Middle-aged chair stands predict mortality risk

The five chair stand test (CST-5) has been used for decades in the elderly to assess physical performance and predict future fall and mortality risk, but its use is less common for middle-aged adults. We examined longitudinal measures of the CST-5, a 60-second assessment of leg strength, endurance, and balance by five repeated stands from a seated position, in a cohort of middle-aged adults and their relation to mortality risk. This longitudinal prospective cohort study examined CST-5 at four visits and mortality over 18 years (2004−2022). Cox regression was used with time-varying covariates to analyze data for 2943 socioeconomically diverse adults aged 30−64 enrolled in Baltimore, Maryland, US. Participants had a mean of 2.5 visits and a mean age of 48.7 years at enrollment and 59.7 years at visit 4. Inability to complete the CST-5 varied from 19% at visit 1 to 31% at visit 4. Half of those unable to complete the CST-5 at visit 1 reported no difficulties getting out of a chair. CST-5 was a significant risk for mortality and inability to complete the test corresponded to more than double (HR: 2.19, 95%CI: 1.65, 2.92) the mortality risk compared with those who completed the test in less than 13.7 seconds. There was no significant difference in mortality risk among those who could complete the exam (slower versus faster HR:1.24, 95%CI: 0.95, 1.62). Inclusion of additional risk factors for mortality did not change the main findings. This longitudinal study demonstrated that the CST-5 is a significant mortality risk in middle-aged adults and that inability to complete the test should be assessed. The CST-5 may provide important clinical information for middle-aged adults in an easy-to-administer test.