Yet Another Way to Predict Mortality

Alvin B. Lin, MD, FAAFP
Dr. Lin is an associate professor of family and community medicine at University of Nevada School of Medicine and an adjunct professor of family medicine and geriatrics at Touro University Nevada College of Medicine. He also serves as an advisory medical director for Infinity Hospice Care and as medical director of Lions HealthFirst Foundation. Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at

As we get older, we try to attempt to predict our mortality, although we readily acknowledge that it's always a guess at best. Physical activity is a wonderful way to give some aid. A corollary is TV watching, also evaluated as sitting time. An adjunct is gait speed and performance of Instrumental Activities of Daily Living. While these individual factors are important, the overall gestalt is obviously even more useful when considered as lifestyle characteristics.

But just like the blind men evaluating an elephant, each assessment at predicting mortality really attempts to sum up the whole person, taking into account physical strength, cardiorespiratory fitness, flexibility, balance, etc. In a retrospective single-center cohort study published last month in the European Journal of Preventive Cardiology, the authors concluded that sitting-rising test (SRT) is a predictor of mortality in 51 to 80 year old participants.

In this study, 2002 men & women 51 to 80 years old were assessed for their ability to sit (on the floor) & rise w/o assistance. Starting with a baseline of 5 points prior to sitting and again prior to standing (maximum score being 10), 1 point was subtracted each time support, eg hand, forearm, knee, or side of leg, etc was used to assist in sitting & rising. Another 0.5 point was subtracted if the author considered a move unsafe or unbalanced. Thus, the lowest score possible was 0 in each direction and 0 when summed up as the SRT score.

Statistically speaking, after an average of 6+ years (ranging as high as 14 yrs) of follow up, those who managed to sit & rise w/minimal intervention/assistance leading to an SRT score of 8-10 had lower mortality by 5-6 fold compared to those who scored 0-3, suggesting an inability to sit & rise independently. The advantage of this particular test is that no timing function is required, nor the need for an open & unobstructed hallway.  


So consider adding this simple & safe test to your armamentarium when attempting to predict mortality in your middle-age to elderly patients.