A simple movement—sitting down and standing up from the floor—may offer more insight into long-term health than it seems.
In a 12-year study of more than 4,000 adults aged 46 to 75 years, researchers found that difficulty performing this basic action was closely linked to the risk of dying from natural and cardiovascular causes.
The test, known as the sitting–rising test (SRT), asks participants to sit on the floor and rise again, ideally without using hands, knees, or any other supports. A perfect execution earns a score of 10, while deductions are applied for each support used or unsteadiness.
Participants were divided into 5 score categories: 0–4, 4.5–7.5, 8, 8.5–9.5, and 10. Over the study period, 665 participants died from natural causes. Mortality rates rose with lower scores—only 3.7% of those who scored 10 died, compared with 42.1% in the lowest group (0–4).
After adjusting for age, sex, body mass index, and clinical history, participants in the lowest scoring group had nearly 4 times the risk of death from natural causes and 6 times the risk of death from cardiovascular causes compared with those who scored 10. Participants with mid-range scores (4.5–7.5) had more than twice the risk of premature death from either natural or cardiovascular causes.
The SRT reflects nonaerobic physical fitness, encompassing muscle strength, flexibility, balance, and body composition—factors that are increasingly recognized as predictors of long-term health.
Among participants who scored 0 on the rising portion of the test, nearly half died during follow-up. In comparison, just 4.4% of those who scored a perfect 5 died of natural causes (1.1% died of cardiovascular causes). Each 1-point drop in the overall SRT score was associated with more than a 30% increase in mortality risk.
The analysis also showed that participants with lower SRT scores were more likely to have health conditions such as diabetes, hypertension, and coronary artery disease. They also had higher BMIs and were less likely to be classified as healthy at baseline.
Data were drawn from a fitness evaluation program in Brazil spanning 25 years. All participants were assessed using standardized protocols by trained physicians. The results suggest that the SRT could be a valuable addition to routine clinical assessments in adults aged 46 and older.
Although the study did not investigate causal mechanisms, the researchers noted that poor SRT performance may indicate underlying musculoskeletal issues, limited mobility, or chronic disease—factors that may collectively increase mortality risk.
The SRT may serve as a practical, low-cost tool in preventive care, helping clinicians identify patients who could benefit from targeted interventions to enhance strength, balance, and mobility.
The authors reported no conflicts of interest.
