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)To read this article in full you will need to make a payment
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References
- Stair negotiation in older people: a review.J Am Geriatr Soc. 2000; 48: 567-580
- A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission.J Gerontol. 1994; 49: M85-M94
- Is stair negotiation measured appropriately in functional assessment scales?.Clin Rehabil. 2003; 17: 325-333
- Risk of admission within 4 weeks of discharge of elderly patients from the emergency department—the DEED study.Age Ageing. 1998; 27: 697-702
- Care needs and level of care difficulty related to hip fractures in geriatric populations during the post-discharge transition period.J Nurs Res. 2006; 14: 251-260
- Functional task benchmarks for stroke rehabilitation.Arch Phys Med Rehabil. 1998; 79: 497-504
- Functional evaluation: the Barthel Index.Md State Med J. 1965; 14: 61-65
- A Guttman health scale for the aged.J Gerontol. 1966; 21: 556-559
- The MOS Short-Form General Health Survey.Med Care. 1988; 26: 724-735
- Self-reported difficulty in climbing up or down stairs in nondisabled elderly.Arch Phys Med Rehabil. 2008; 89: 100-104
- Energy cost of stair climbing and descending on the college alumnus questionnaire.Med Sci Sports Exerc. 1997; 29: 1250-1254
- Is stair climb power a clinically relevant measure of leg power impairments in at-risk older adults?.Arch Phys Med Rehabil. 2007; 88: 604-609
- Assessing advanced locomotor recovery after total hip arthroplasty with the timed stair test.Clin Rehabil. 2003; 17: 780-786
- Leg extensor power and functional performance in very old men and women.Clin Sci (Lond). 1992; 82: 321-327
- Determinants for stair climbing by elderly from muscle morphology.Percept Mot Skills. 2002; 94: 814-816
- Physical and psychological factors associated with stair negotiation performance in older people.J Gerontol A Biol Sci Med Sci. 2007; 62: 1259-1265
- Interrater reliability and validity of the stair ascend/descend test in subjects with total knee arthroplasty.Arch Phys Med Rehabil. 2010; 91: 932-938
- Assessing stability and change of four performance measures: a longitudinal study evaluating outcome following total hip and knee arthroplasty.BMC Musculoskelet Disord. 2005; 6: 3
- Epidemiology of gait disorders in community-residing older adults.J Am Geriatr Soc. 2006; 54: 255-261
- Diagnostic and statistical manual of mental disorders.4th ed. APA, Washington, DC1994
- Within-person across-neuropsychological test variability and incident dementia.JAMA. 2008; 300: 823-830
- Cognitive processes related to gait velocity: results from the Einstein Aging Study.Neuropsychology. 2006; 20: 215-223
- Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community sample of the oldest old.Int J Geriatr Psychiatry. 2003; 18: 63-66
- The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects.Br J Psychiatry. 1968; 114: 797-811
- Occupational Safety and Health Standards.(Accessed April 22, 2011)
- The burden and patterns of disability in activities of daily living among community-living older persons.J Gerontol A Biol Sci Med Sci. 2003; 58: 70-75
- Physical performance measures in the clinical setting.J Am Geriatr Soc. 2003; 51: 314-322
- Assessment of function and disability in longitudinal studies.J Am Geriatr Soc. 2010; 58: S308-S312
- Prognostic value of usual gait speed in well-functioning older people—results from the Health, Aging and Body Composition Study.J Am Geriatr Soc. 2005; 53: 1675-1680
- Proportional hazards tests and diagnostics based on weighted residuals.Biometrika. 1994; 81: 515-526
- Old adults perform activities of daily living near their maximal capabilities.J Gerontol A Biol Sci Med Sci. 2003; 58: M453-M460
- Stair performance in people aged 75 and older.J Am Geriatr Soc. 2004; 52: 563-567
- The demands of stair descent relative to maximum capacities in elderly and young adults.J Electromyogr Kinesiol. 2008; 18: 218-227
- Influence of light handrail use on the biomechanics of stair negotiation in old age.Gait Posture. 2008; 28: 327-336
Article info
Footnotes
Supported by the National Institute on Aging (grant no. RO1 AG025119), and in part by a National Institutes of Health (NIH) Clinical and Translational Science Award from the National Center for Research Resources (grant nos. UL1 RR025750, KL2RR025749), a component of the NIH, and NIH Roadmap for Medical Research.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Reprints are not available from the authors.
Identification
Copyright
© 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
