Ability to sit and rise from the floor is closely correlated with all-cause mortality risk

In 2002, over 2000 people between the ages of 51 and 80 were asked to sit on the floor using as little hand- or knee-support as possible. They were then asked to stand up without resorting to using their hands or knees if they were able. The results were recorded. By the end of October 2011, 159 subjects had died. It turns out that most of the people who died were the ones who needed the most support while performing the task. Only 2 of the 159 people who died had been able to sit down and stand up unsupported: "These differences persisted when results were controlled for age, gender and body mass index, suggesting that the sitting-rising test score is a significant predictor of all-cause mortality."

Test of musculo-skeletal fitness is 'strong predictor' of mortality in the middle-aged and older (Via Seth Robert's Blog)



  1. In other words: If you are too sick to get up on your own and in the 51-80 age bracket its likely that you’ll kick the bucket soon.

    1. No yeah, I found that very confusing too. That’s much less worrisome an idea, that people with good mobility are at a lower risk of dying!

    2. No, because „ability“ isn’t a (positive) absolute, but gradual.

      The line is perfectly correct: The better your ability in sitting and risingm the higher your chance to get older.

  2. Hmmm… so you’re saying there’s a correlation between physical fitness and overall health. Balderdash, I say!!!!

    1. Exactly. I know you’re being funny here, but this is the exact situation that gets people into trouble – it’s not as if it’s a realistic idea to avoid sitting on the floor for the rest of your life.

      Also, if you are going to fall while doing this, it’s best to be near a doctor when it happens. 

  3. I’m quite surprised I can’t stand up the way they suggest. I’m almost 40, exercise regularly, have good flexibility and a healthy weight. Is it a lack of core muscle strength? Every time I lean forward to stand I can’t get my body mass balanced over my feet and just rock back to a seated position. However, if I place me feet wide apart, knees uncrossed, I can stand easily. Not sure if that’s good or bad.

    1. If you can’t get your heels to the floor, you’re going to have to balance on your toes, which is fairly difficult. It may be flexibility, rather than strength, that correlates with not dying.

      1. I can definitely get my heels on the floor, and I can stand up on my left foot only while using just my right leg for balance quite easily, no hands. Perhaps I have been favoring my left leg for so long (crushed the cartilage in my right knee as a teenager) that I am now out of balance…

        1. My heels won’t go down, despite me being hyperflexible.  It’s a structural foot issue for many people.

          I also have bad knees, including an old ax wound.  If you’re very careful, let your butt muscles do most of the work, and avoid any lateral movement or torque, you can do quite a bit with bad knees, although I wouldn’t do it repetitively.

    2.  It’s going to depend on your hip structure and the lengths of certain bones. There are individual variations among humans that make things like that work differently from one person to another. I can easily do the crossed-leg stand, but if I try to sit down with my shins uncrossed, that last few inches is more of a ‘falling down.’ I’m pretty impressed that you can stand the way you describe from a fully seated position.

    3.  Imo, nothing to worry about. People are different and what I like about this test is that it takes it into account quite elegantly. How exactly you get off the floor is immaterial, the only thing that counts is how much extra support you need and whether you loose balance at any point.

    4. I’ve hear too that there are nerves in our feet that wither away with age. These usually send minute signals to our brain that our autonomous nervous systems use to automatically adjust our balance. As we age, these signals get slower and what can happen is that we find ourself already past our balance point by the time the brian figures out we’re unbalanced… by which time it’s too late and we fall.

      At any rate, I encourage you to practice and work more at squats. Strengthen those legs!

  4. What’s the metric of “need” support in this case? I can stand up unsupported, but it’s not easy. Not impossible either.

  5. So, I happened to have a pad and some time just now.  Got down no problem, maybe a 4.5 slight loss of balance.  Standing up I nearly got there and then staggered backwards falling into some stuff.  Nearly died right then.


  6. So glad I watched the video for clarification, because I could not understand how one could sit or get back up without knees.

    I wonder if the study differentiated between general difficulty with the task vs difficulty due to knee damage from heavy involvement in certain sports or dance when young?

  7. Little exercises like that in my daily life are more and more important now that I’m in my fifties. Balance is something I took for granted in my youth; I’ve since come to understand how important “core strength” is to balance, and vice-versa. Getting old sucks, but getting old slower than necessary is a simple maintenance issue that all responsible owners can and should follow.

  8. At 58 I am scoring a 5/3.  Or something like that.  I can get down unassisted but getting backup requires either rolling onto my knees and then getting up (is that a lateral use of the the leg?) or using an arm or two.

    I am reading a book called “Balance … In search of the lost sense” by McCredie which talks about how important balance is to human survival.  The test in the video has a lot to do with balance (plus overall strength) thus goes along well with my current reading.

  9. When I was teaching yoga, I’d make my students put their hands on their heads while they got up and down.  Their eyes would race from side to side hoping for a distraction so that they could get a hand down while I wasn’t looking.

  10. Well, if they were asked to do it once it only talks about their muscular development while if they had to do repetitions they were meassuring the aerobic capabilities (ie their heart). Still if weren’t able to do just one it is reasonable to think that they weren’t in very good shape and should have encourage to improve their shape as much as possible.

    For funding, research and peer finding please refer to the non-profit Aging Portfolio.


  11. A willingness to cooperate with absurd and humiliating physical tests appears to be weakly correlated with healthcare outcomes; however, the hypothesis cannot be verified because not one of the 2,000 test subjects refused.

  12. Brilliant test. Sadly, it’ll never get traction in “mainstream” medicine because you can’t sell expensive patent gadgetry and training for it.

    I’m not a medical professional, but I can see how useful this test might be when trying to get some kind of a rough but measurable and exact fitness assessment for a large number of people very fast; giving a simple self-monitoring tool to a patient trying to improve fitness; a very visual, clear and intuitive indicator – both in group and individual situations…
    If you are trying to get your PE class kids to work on themselves, I can’t see a better way than to introduce them to SRT and make it into a game…

  13. I score very low. I would have scored very low when I was 20. I’m about as flexible as your average iron bar and no amount of stretching seems to do anything but cause me untold pain. I hope this doesn’t mean I’m slated for imminent death.

  14. This test is conceptually very similar to the “get up and go” test that physicians learn in medical school (even in the US).  And, yes, I use it in my residency training.  The test is to have someone get out of a chair, walk across the room, turn, walk back to the chair, and sit down.  If it takes them more than 10 seconds, you’re supposed to do further evaluation.  As far as I know, though, the get up and go test has not been studied in large populations like this for mortality risk.

  15.  Suppose I give up on traditional cardio/strength training, and simply work on sitting on the floor and standing up again. Can I extend my life?

    (Oddly enough, as I age, I get shorter and shorter, yet the floor moves further and further away.)

  16. Yeah, scoring a 10 seems to be a marker of excellent agility and decent strength. Or perhaps I just say that our of reflexive defensiveness after scoring a 9. But seriously, I can squat more than my bodyweight for 5, touch my palms to the floor and balance for minutes on my non-dominant foot with my eyes closed. People who scare a 10 are too awesome to die.

    1. Balance and flexibility. I’m actually really out of shape and have not worked out regularly in over a year. However I can do this easily both sitting and rising, to the point of being able to spring back up and hover down. It makes me pretty winded though! I am not strong at all, and actually not in the greatest of health this past year though I’m doing better right now. 

      I could not squat 30 pounds. I’m not sure what the second thing you describe looks like, but I imagine I could not do it unless you are just bending over and not holding a squat.

      The only advantages I have are body structure, medium to light weight, natural flexibility combined with residual flexibility that has probably not gotten too bad after a year or so of not keeping up with things.

  17. Basic balance, agility and control is probably a factor in how someone recovers from the various slips and trips and missteps that we all do frequently.  For some people those are just a slight wobble and for others it’s a trip to the ground with a head injury or broken hip the result and that will cascade into greater mortality eventually.

  18.  Hell, I can’t even sit up like that unassisted. Though I have extremely tight tendons (medically verified on multiple occasions).

  19. Tai Chi helps develop some of the strengths needed to do this, and is anecdotally linked to longer life.   

  20. This is vaguely interesting, but it’s not really of much use unless it can be shown that taking steps to improve your ability to get up from the floor translates into longer life.  Aside from the significantly obese, who rather obviously have other mortality risks, this test may really be more of a marker than an indicator of treatment.  Perhaps simply assigning people with balance & strength problems to use a cane or walker would reduce their death risk, for example.  It depends rather a lot on just what all the people died of.  BTW, I’m optimistically assuming the study authors had the common sense to exclude parapelegics from the test group :-)

Comments are closed.