How You Sit and Rise Predicts Longevity

You might want to sit down for this — then stand up as smoothly as you can.

The ease with which a person can sit on the floor and rise to their feet, using as little support as possible, may help predict how long they will live.

Adults who aced the so-called sitting-rising test were far less likely to die of natural or cardiovascular causes over about 12 years of follow-up than those who scored the lowest, according to a study published online on June 18 in the European Journal of Preventive Cardiology.

The study added to the body of evidence showing that various measures of physical function beyond aerobic fitness, including flexibility, the ability to stand on one leg, and grip strength, can predict longevity.

The sitting-rising test measures several key components of non-aerobic fitness at once, including muscle strength or power, flexibility, balance, and body composition, without the use of any equipment, according to the researchers.

The study by Claudio Gil S. Araújo, MD, PhD, dean of research and education at Clinimex, an exercise medicine clinic in Rio de Janeiro, Brazil, and colleagues expands on a 2012 study that found scores on the test were associated with all-cause mortality.

10 Points Possible

To get a perfect score on the sitting-rising test, you must complete the tasks without using your hands, forearms, knees, or the side of your legs for support, and you must remain steady.

If you start to lose your balance or, say, need to kneel or put a hand down to support yourself, you start to lose points from a perfect 10 (5 points possible for sitting and 5 for standing).

If you cannot complete the tasks without external help such as a table, wall, or another person, you score a 0. (This video illustrates the test and scoring.)

The investigators analyzed data of 4282 individuals (age, 46-75 years; 68% men) who completed the sitting-rising test as part of a voluntary fitness evaluation between 1998 and 2023. None had physical or clinical limitations that restricted their participation in the fitness tests.

During a median follow-up of 12 years, 665 participants died of natural causes (15.5%). Among those who scored a 10 on the sitting-rising test, 3.7% died. Of those who scored an 8 on the test, 11.1% died. Among participants with the lowest scores (0-4) on the sitting-rising test, 42.1% died.

In an analysis that adjusted for age, sex, BMI, and clinical variables, the researchers found people who scored the lowest were 3.8 times more likely to die of natural causes and six times more likely to die of cardiovascular causes than those with the highest score.

Key questions remain, the authors acknowledged: What “exercise prescription” would best improve or maintain sitting-rising test scores? Would improving the scores prolong survival? And how do predictions based on this non-aerobic fitness measure compare with those based on aerobic fitness tests?

More Than Swimming

Clinicians and researchers are increasingly recognizing the role that non-aerobic fitness plays in health, said Daniel Forman, MD, with the University of Pittsburgh and the Veterans Affairs Pittsburgh Healthcare System, both in Pittsburgh. A recent statement on the core components of cardiac rehabilitation programs, which Forman co-authored, highlights the importance of strength training and physical activity, in addition to aerobic exercise, which had historically been the focus.

“It’s not enough to think that ‘I have to go swimming several times a week,’” Forman said. “We are talking now about adding in strength training at least twice a week. And it is just as essential if not more so to prevent decline.”

Rising from a seated position is a dynamic exercise that incorporates strength and balance, and difficulty performing this action can reveal impairment, Forman said.

While many clinics in the US would not necessarily be set up to conduct the sitting-rising test, it is inexpensive and yields important information, Forman said. The underlying principle may be more important than the exact technique used to test and score physical abilities, he said.