Low relative sit-to-stand power is associated with history of falls and fractures, prospective hospitalization, and all-cause mortality in older adults from the Toledo study for healthy aging.
Level 3 - non-randomized controlled study
Prospective cohort study evaluating long-term hospitalization and all-cause mortality outcomes.
PubMed 40816636 · doi:10.1016/j.jshs.2025.101080
What was done
Data from 1,876 older adults (aged ≥65 years, 56.4% women) from the Toledo Study for Healthy Aging were analyzed. Relative sit-to-stand (STS) power was estimated using the 30-second STS test and the Alcazar equation, applying established cut-offs (2.53 W/kg for men, 2.01 W/kg for women). Falls and fractures (hip and all-type) in the prior year were recorded. Prospective outcomes were hospitalizations (mean follow-up 6.8 ± 3.1 years; median 7.8 years) and all-cause mortality (mean follow-up 9.7 ± 3.5 years; median 10.9 years). Generalized linear mixed models, binary logistic regression, and proportional hazards regression adjusted for age, educational level, and comorbidities were used.
What was found
In men, low relative STS power was associated with a higher likelihood of falls in the previous year (OR = 1.73, 95% CI: 1.08–2.75, p = 0.022) and all-type fractures (OR = 1.86, 95% CI: 1.21–2.84, p = 0.004). In women, low relative STS power was associated with previous-year hip fractures (OR = 3.25, 95% CI: 1.07–9.86, p = 0.038). Prospectively, low relative STS power predicted hospitalizations in women (HR = 1.29, 95% CI: 1.06–1.58, p = 0.012) and longer hospital stays in both men (p = 0.020) and women (p = 0.033). Low relative STS power significantly increased all-cause mortality in both men (HR = 1.57, 95% CI: 1.26–1.97, p < 0.001) and women (HR = 2.04, 95% CI: 1.51–2.74, p < 0.001).
Why it matters
Sit-to-stand relative muscle power calculated from a simple chair-stand test provides an accessible prognostic marker for prospective hospitalization and long-term mortality in older adults.
Limits
Falls and fractures were ascertained retrospectively for the prior year, introducing potential recall bias and limiting causal interpretation for injury outcomes. STS power was estimated via an equation rather than direct force-plate measurement. Findings are from a single regional cohort in Spain.
Cited by
- supports Accelerated loss of muscle power with aging (powerpenia) is strongly associated with fall risk, bone fractures, and joint dislocations, particularly after age 60 or 65.