title: Stair negotiation time in community-dwelling older adults: normative values and association with functional decline.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Longitudinal cohort study. Mean follow-up time was 1.8 years (maximum, 3.2y; total, 857.9 person-years).
  
  
  METHODS
  Community sample.
  
  
  METHODS
  Adults 70 years and older (N=513; mean age, 80.8 ± 5.1y) without disability or dementia.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  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.
authors: Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA. mohpark@montefiore.org
authors: Mooyeon
authors: M
authors: Oh-Park
authors: Cuiling
authors: C
authors: Wang
authors: Joe
authors: J
authors: Verghese
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D015444:Exercise; D005239:Fear; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D013647:Task Performance and Analysis; D016138:Walking / Q000502:physiology* / Q000523:psychology