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Physical and Psychological Factors Associated With Stair Negotiation Performance in Older People

¹ Prince of Wales Medical Research Institute, University of New South Wales, Sydney, Australia.
² School of Public Health, University of Sydney, Australia.

Address correspondence to Stephen Lord, PhD, DSc, Prince of Wales Medical Research Institute, Barker Street, Randwick, NSW, 2031, Australia. E-mail: s.lord{at}unsw.edu.au

Background. An inability to negotiate stairs is a marker of disability and functional decline and can be a critical factor in loss of independence in older people. There is limited research on the underlying factors that impair performance in this important activity of daily living. We examined which physical and psychological factors are associated with stair climbing and stair descending performance in older people.

Methods. Six hundred sixty-four community-dwelling people aged 75–98 years (mean age = 80.1 years, standard deviation (SD) = 4.4 years) underwent stair negotiation tests as well as tests of lower limb strength, vision, peripheral sensation, reaction time, and balance and completed questionnaires measuring psychological and health status.

Results. Many physiological and psychological factors were significantly associated with stair negotiation speed. Multiple regression analyses revealed that knee extension and knee flexor strength, lower limb proprioception, edge contrast sensitivity, reaction time involving a foot-press response, leaning balance, fear of falling, and the Short-Form 12 Health Status Questionnaire (SF-12) pain and vitality scores were significant and independent predictors of stair ascent and descent performance. The combined set of variables explained 47% of the variance in stair ascent performance and 50% of the variance in stair descent performance. Measures of strength, balance, vision, fear, and vitality also significantly discriminated between persons who did and did not require the use of the handrail when performing the tests.

Discussion. In community-dwelling older people, impaired stair negotiation is associated not only with reduced strength but also with impaired sensation, strength, and balance; reduced vitality; presence of pain; and increased fear of falling.