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Stair Negotiation Time in Community-Dwelling Older Adults: Normative Values and Association With Functional Decline

  • Mooyeon Oh-Park
    Correspondence
    Correspondence to Mooyeon Oh-Park, MD, Dept of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, 1165 Morris Park Ave, Room 338, Bronx, NY 10461
    Affiliations
    Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY

    Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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  • Cuiling Wang
    Affiliations
    Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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  • Joe Verghese
    Affiliations
    Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY
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      Abstract

      Oh-Park M, Wang C, Verghese J. Stair negotiation time in community-dwelling older adults: normative values and association with functional decline.

      Objectives

      To establish reference values for stair ascent and descent times in community-dwelling, ambulatory older adults, and to examine their predictive validity for functional decline.

      Design

      Longitudinal cohort study. Mean follow-up time was 1.8 years (maximum, 3.2y; total, 857.9 person-years).

      Setting

      Community sample.

      Participants

      Adults 70 years and older (N=513; mean age, 80.8±5.1y) without disability or dementia.

      Interventions

      Not applicable.

      Main Outcome Measures

      Time to ascend and descend 3 steps measured at baseline. A 14-point disability scale assessed functional status at baseline and at follow-up interviews every 2 to 3 months. Functional decline was defined as an increase in the disability score by 1 point during the follow-up period.

      Results

      The mean±SD stair ascent and descent times for 3 steps were 2.78±1.49 and 2.83±1.61 seconds, respectively. The proportion of self-reported and objective difficulty was higher with longer stair ascent and descent times (P<.001 for trend for both stair ascent and descent). Of the 472 participants with at least 1 follow-up interview, 315 developed functional decline, with a 12-month cumulative incidence of 56.6% (95% confidence interval [CI], 52.1%–61.3%). The stair negotiation time was a significant predictor of functional decline after adjusting for covariates including gait velocity (adjusted hazard ratio [aHR] per 1-s increase: aHR=1.12 [95% CI, 1.04–1.21] for stair ascent time; aHR=1.15 [95% CI, 1.07–1.24] for stair descent time). Stair descent time was a significant predictor of functional decline among relatively high functioning older adults reporting no difficulty in stair negotiation (P=.001).

      Conclusions

      The stair ascent and descent times are simple, quick, and valid clinical measures for assessing the risk of functional decline in community-dwelling older adults including high-functioning individuals.

      Key Words

      List of Abbreviations:

      ADLs (activities of daily living), aHR (adjusted hazard ratio), CI (confidence interval)
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