Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Yeshiva University, Bronx, NY 10461, USA.
Arch Phys Med Rehabil. 2011 Dec;92(12):2006-11. doi: 10.1016/j.apmr.2011.07.193.
To establish reference values for stair ascent and descent times in community-dwelling, ambulatory older adults, and to examine their predictive validity for functional decline.
Longitudinal cohort study. Mean follow-up time was 1.8 years (maximum, 3.2y; total, 857.9 person-years).
Community sample.
Adults 70 years and older (N=513; mean age, 80.8 ± 5.1y) without disability or dementia.
Not applicable.
Time to ascend and descend 3 steps measured at baseline. A 14-point disability scale assessed functional status at baseline and at follow-up interviews every 2 to 3 months. Functional decline was defined as an increase in the disability score by 1 point during the follow-up period.
The mean±SD stair ascent and descent times for 3 steps were 2.78 ± 1.49 and 2.83 ± 1.61 seconds, respectively. The proportion of self-reported and objective difficulty was higher with longer stair ascent and descent times (P<.001 for trend for both stair ascent and descent). Of the 472 participants with at least 1 follow-up interview, 315 developed functional decline, with a 12-month cumulative incidence of 56.6% (95% confidence interval [CI], 52.1%-61.3%). The stair negotiation time was a significant predictor of functional decline after adjusting for covariates including gait velocity (adjusted hazard ratio [aHR] per 1-s increase: aHR=1.12 [95% CI, 1.04-1.21] for stair ascent time; aHR=1.15 [95% CI, 1.07-1.24] for stair descent time). Stair descent time was a significant predictor of functional decline among relatively high functioning older adults reporting no difficulty in stair negotiation (P=.001).
The stair ascent and descent times are simple, quick, and valid clinical measures for assessing the risk of functional decline in community-dwelling older adults including high-functioning individuals.
为社区居住、能行走的老年人确定上下楼梯时间的参考值，并检验其对功能下降的预测效度。
纵向队列研究。平均随访时间为 1.8 年（最长 3.2 年；总随访时间为 857.9 人年）。
社区样本。
无残疾或痴呆的 70 岁及以上成年人（N=513；平均年龄 80.8±5.1 岁）。
不适用。
在基线时测量上、下 3 级楼梯的时间。在基线和每 2~3 个月的随访访谈时使用 14 分残疾量表评估功能状态。功能下降定义为随访期间残疾评分增加 1 分。
上、下 3 级楼梯的平均（±SD）时间分别为 2.78±1.49 秒和 2.83±1.61 秒。上、下楼梯时间较长者报告主观和客观困难的比例更高（趋势 P<.001）。在至少有 1 次随访访谈的 472 名参与者中，315 名发生了功能下降，12 个月累积发生率为 56.6%（95%置信区间[CI]，52.1%-61.3%）。调整包括步态速度在内的协变量后，楼梯协商时间是功能下降的显著预测因素（每增加 1 秒，上楼梯时间的校正后危险比[aHR]：aHR=1.12[95%CI，1.04-1.21]；下楼梯时间的 aHR=1.15[95%CI，1.07-1.24]）。在报告楼梯协商无障碍的高功能老年人中，下楼梯时间是功能下降的显著预测因素（P=.001）。
上、下楼梯时间是评估社区居住的老年人（包括高功能个体）功能下降风险的简单、快速、有效的临床指标。
