title: Climbing Stairs, Handrail Use, and Survival.
abstract: Negotiating stairs is identified as a challenging task by older people, and using a handrail to climb stairs is a compensatory gait strategy to overcome mobility difficulties. We examine the association between handrail use to climb stairs at increasing ages, and long term survival.
  
  
  
  Data were collected by the Jerusalem Longitudinal Study, which is a prospective study of a representative sample from the 1920-1921 birth-cohort living in West Jerusalem. Comprehensive assessment at home in 1990, 1998, and 2005, at ages 70 (n=446), 78 (n=897), and 85 (n=1041) included direct questioning concerning handrail use for climbing stairs. Mortality data were collected from age 70-90.
  
  
  
  The frequency of handrail use to climb stairs at ages 70, 78, 85 years was 23.1% (n=103/446), 41.0% (n=368/897), and 86.7% (n=903/1041) respectively. Handrail use was associated throughout follow-up with a consistent pattern of negative demographic, functional and medical parameters. Between ages 70-78, 70-90, 78-85, 78-90, and 85-90, survival was significantly lower among subjects using a handrail, with unadjusted mortality Hazard Ratios of HR 1.57 (95%CI, 1.01-2.42), HR 1.65 (95%CI, 1.27-2.14), HR 1.78 (95%CI, 1.41-2.25), HR 1.71 (95%CI, 1.41-2.06), and HR 1.53 (95%CI, 1.01-2.33) respectively. HR's remained significant at all ages after adjusting for sociodemographic factors (gender, education, marital, and financial status), and common medical conditions (ischemic heart disease, hypertension, diabetes, chronic pain), as well as between ages 78-85 and 78-90 after adjusting for functional covariables (self-rated health, physical activity, depression, BMI and ADL difficulties).
  
  
  
  Using a handrail to climb stairs is increasingly common with rising age, was associated with a negative profile of health parameters and is associated with subsequent mortality.
authors.affiliation: Professor Jochanan Stessman, Institute of Aging Research, Department of Geriatrics and Rehabilitation, Hadassah Hebrew-University Medical Center, Mt. Scopus. P.O. Box 24035, Jerusalem 91240, Israel. E-mail: jochanans@ekmd.huji.ac.il, Tel: 972-2-5844474, Fax: 972-2-5810918.
authors.forename: J
authors.initials: J
authors.lastname: Stessman
authors.forename: Y
authors.initials: Y
authors.lastname: Rottenberg
authors.forename: J M
authors.initials: JM
authors.lastname: Jacobs
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D057187:Independent Living; D008137:Longitudinal Studies; D008297:Male; D009026:Mortality; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012959:Socioeconomic Factors; D000072799:Stair Climbing / Q000502:physiology*