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. Author manuscript; available in PMC: 2015 Sep 29.
Published in final edited form as: J Am Geriatr Soc. 2009 Nov;57(11):2172–2173. doi: 10.1111/j.1532-5415.2009.02544.x

CHAIR STANDS TEST AND SURVIVAL IN THE OLDER POPULATION

Stefania Bandinelli 1, Yuri Milaneschi 2, Luigi Ferrucci 3
PMCID: PMC4587495  NIHMSID: NIHMS716710  PMID: 20121975

To the Editor

In their manuscript recently published, Cesari et al.1 suggested that scores on the three subcomponents of the Short Physical Performance Battery (SPPB), namely timed usual gait speed, standing balance, and repeated chair stand, are equally predictive of the risk of adverse health events in older persons and their predictive validity is only slightly inferior to the complete SPPB score. These findings were replicated in the Invecchiare in Chianti (InCHIANTI) Study in a representative sample of the older Italian population2 including 993 participants aged 65 and older without disabilities in activities of daily living (ADLs) at enrollment. In particular, the hypothesis that the chair stands subtest, which can be easily performed even in a small outpatient clinic, is a valid tool for the assessment of risk of death in community-dwelling older persons was tested. Over 9 years of follow-up, there were 246 deaths. Using a receiver operating characteristic (ROC) analysis, no significant differences were found in death prediction between the chair stand (area under the ROC curve (AUC) = 0.66, 95% confidence interval (CI) = 0.63–0.69), walking (AUC = 0.65, 95% CI = 0.62–0.69), and balance (AUC = 0.68, 95% CI = 0.65–0.71). Using the original scoring method3 and adjustment for age, sex, Mini-Mental State Examination score, coronary artery disease, and smoking habits, those with a repeated chair stand scores of 0, 1, and 2 were, respectively, 2.3 times (95% CI = 1.3–4.1, P = .004), 2.0 times (95% CI = 1.3–3.0, P = .002), and 1.8 times (95% CI = 1.2–2.7, P = .008) as likely to die during follow-up as those with a score of 4 (shortest time) (Figure 1). Because the space necessary to complete the walking test is often not available in an ambulatory or home setting, the chair stand test is a valid and simple alternative to measure lower extremity performance.

Figure 1.

Figure 1

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Survival curves during the 9 years of follow-up according to time to complete the chair stand test.

Acknowledgments

The InCHIANTI study baseline (1998–2000) was supported as a “targeted project” (ICS110.1/RF97.71) by the Italian Ministry of Health and in part by the U.S. National Institute on Aging (NIA; Contracts 263 MD 9164 and 263 MD 821336); the InCHIANTI Follow-up 1 (2001–2003) was funded by the NIA (Contracts N.1-AG-1-1 and N.1-AG-1-2111); the InCHIANTI Follow-up 2 and 3 studies (2004–2010) were financed by the NIA (Contract N01-AG-5-0002) and supported in part by the Intramural Research Program of the NIA, National Institutes of Health, Baltimore, Maryland.

Footnotes

Conflict of Interest: The authors declare that they have no conflict of interest to disclose concerning this letter.

Author Contributions: All of the authors took part in every aspect of this letter, including the design and preparation and writing of the letter.

Sponsor’s Role: None.

Contributor Information

Stefania Bandinelli, Geriatric Unit, Azienda Sanitaria diFirenze, Florence, Italy.

Yuri Milaneschi, Tuscany Health Regional Agency, Florence, Italy.

Luigi Ferrucci, Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, Maryland.

References

  • 1.Cesari M, Kritchevsky SB, Newman AB, et al. Health, Aging and Body Composition Study: Added value of physical performance measures in predicting adverse health-related events: Results from the Health, Aging and Body Composition Study. J Am Geriatr Soc. 2009;57:251–259. doi: 10.1111/j.1532-5415.2008.02126.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
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  • 3.Guralnik JM, Ferrucci L, Simonsick EM, et al. Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability. N Engl J Med. 1995;332:556–561. doi: 10.1056/NEJM199503023320902. [DOI] [PMC free article] [PubMed] [Google Scholar]

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