A large-scale study of mobility and mortality suggests that a simple test of your balance, strength and flexibility, known as the sitting-rising test, could be an early indicator of how long you’ll live, according to the scientists.
However, other experts argue that it could be daunting or inappropriate for some people, and is not “a foolproof” indicator of our longevity.
The study, published in the European Journal of Preventive Cardiology, looked at how well 4 282 men and women aged between 46 and 75 could – from a standing position – lower themselves to the floor and then stand back up again with as little assistance as possible from their hands, knees, furniture or human helpers.
The test assesses “all of the aspects of fitness that are not aerobic”, said Claudio Gil Araújo, the study’s lead author and research director at an exercise-medicine clinic in Rio de Janeiro, where the data were collected.
Those aspects include muscular health, balance, flexibility and body composition, he said, each of which is important for longevity and health.
The Washington Post reports that in the study, middle-aged and older people who needed no support to sit or stand were about six times less likely to die of heart disease and other cardiovascular conditions during the next decade or so than people who wobbled and had great difficulty completing the task.
They also were less likely to die of other natural causes, including cancer.
There are many tests of balance or strength or flexibility, Araújo said. “But what makes this test special is that it looks at all of them at once, which is why we think it can be such a strong predictor of longevity,” he said.
He added that people with disabilities or serious joint problems, such as hip, spine or knee arthritis, probably shouldn’t do the test, as it could cause unnecessary pain or injury.
In the study, men and women who scored between zero and four were far more likely to die of cardiovascular problems and other natural causes during about a 12-year-long follow-up period than those scoring a perfect 10. (The scientists screened out deaths from suicides or accidents, such as car crashes, that wouldn’t be considered natural causes.)
Men and women scoring between 4.5 and 7.5 had about a threefold heightened risk of dying during the follow-up period, compared with those who scored a 10.
A relatively low score, below about a 7.5 for healthy middle-aged and older people, “should be a cause for some concern”, Araújo said. He’s 69 and recently scored an 8.5, he said. (No one in the study group was older than 75, so it’s not clear if the findings apply to anyone 76 or older.)
These new results update a 2014 study from Araújo’s group that likewise showed an association between how people scored and their longevity.
A score between eight and 10 “indicated a particularly low risk of death” in subsequent years, Araújo and his co-authors wrote.
That study involved about 2 000 men and women and a follow-up period of about six years. The new study doubled both the participants and follow-up time, making the updated results “that much stronger” he said.
Low score can be a ‘wake-up call’
The sitting-rising test is not a foolproof indicator of our health or longevity, though. It incorporates so many aspects of fitness, for one thing, it’s hard to know which are weakest if our scores are low, said Avril Mansfield, a Professor of Physical Therapy at the University of Toronto, who studies mobility and balance.
She wasn’t involved with the new study.
The test also could be daunting or inappropriate for many people, said Lora Giangregorio, a Professor at the University of Waterloo in Canada who studies falls and bone health and also wasn’t involved with the study.
“It requires people to get off of the floor in a prescribed way that requires very good joint mobility.”
If you have joint pain or other disabilities or are older and feel infirm, other tests of mobility are likely to be safer and more reliable, she said.
She suggested people should try, for instance, the 30-second chair stand test, which is recommended by the US Centres for Disease Control and Prevention to assess physical performance in older people.
Simply count how many times you can rise from and sit back on to a chair seat in 30 seconds, without using your hands. Men younger than 60 should manage, at minimum, 15, and women that age at least 13.
Average scores decline by one or two per decade after that.
Underlying
The sitting-rising test and the new study also don’t tell us why the test predicts mortality, although Araújo believes low scores indicate underlying disease and frailty.
People who are inflexible also often have stiff arteries, he said, contributing to heart disease, while people with poor balance could be predisposed to serious falls, which can precipitate physical decline and death.
Perhaps most important, though, a low score is a portent, but not a promise, he said. “People ask, ‘If my score is low, does that mean I’ll be dead in five years?’ Of course not,” Araújo said. But it can be a wake-up call. “It’s telling you, maybe you need to make some changes.”
Study details
Sitting–rising test scores predict natural and cardiovascular causes of deaths in middle-aged and older men and women
Claudio Gil Araújo, Christina de Souza e Silva, Jonathan Myers et al.
Published in European Journal of Preventive Cardiology on 18 June 2025
Abstract
Aims
In a previous study, the ability to sit and rise from the floor was associated with all-cause mortality. Now, we aim to assess whether sitting–rising test (SRT) scores also predict premature natural and cardiovascular (CV) deaths. This is a prospective cohort design study.
Methods and results
A total of 4282 adults aged 46–75 years (68% men) performed sitting and rising from the floor, which was scored from 0 to 5, with one point being subtracted from 5 for each support used (hand/knee) and 0.5 for an unsteadiness execution. The final SRT score was obtained by adding sitting and rising scores and stratified in five groups for analysis: 0–4, 4.5–7.5, 8, 8.5–9.5, and 10. During a median follow-up of 12.3 (interquartile range = 7.6–18.0) years, there were 665 deaths (15.5%). There was a continuous trend for higher mortality with low SRT scores (P < 0.001), with death rates of 3.7, 7.0, 11.1, 20.4, and 42.1%, respectively, for Groups 5 to 1 of SRT scores. The Cox multivariate-adjusted (age, sex, body mass index, and clinical variables) hazard ratios of 3.84 [95% confidence interval (CI) 2.25–6.97] and 6.05 (95% CI 2.29–20.94) (P < 0.001) were observed, respectively, for natural and CV mortality, when comparing the highest and lowest SRT score groups.
Conclusion
Non-aerobic physical fitness, as assessed by SRT, was a significant predictor of natural and CV mortality in 46–75-year-old participants. Application of the SRT, a simple assessment tool that is influenced by muscular strength/power, flexibility, balance, and body composition, could add relevant clinical and prognostic information to routine examinations of healthy and unhealthy individuals.
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