The Sit-to-Stand Test: A Longevity Predictor in 30 Seconds

How the sitting-rising test is scored

Starting from standing, in comfortable clothing that allows free movement, you lower yourself to a fully seated position on the floor, then rise back to standing, using as little external support as possible. You begin with 5 points for the sitting-down phase and 5 points for the standing-up phase, 10 total, and subtract one point each time you use a hand, a knee, a forearm, or the side of your leg for support during either phase. Losing your balance at any point during the test also costs a point.

A perfect 10 means sitting down and standing back up entirely unassisted, using only your legs and core for balance and control, no hands touching the floor, no knee touching down, no wobble requiring you to catch yourself. Most reasonably fit younger adults can do this without difficulty, it's older age, reduced mobility, and reduced leg strength that typically bring the score down. A score of 8, using just one point of support in total across both directions, is still a strong, respectable result and the threshold generally used to define the lower boundary of "good" in the research below.

The scoring treats each phase as its own 5-point component, sitting down and standing back up, because some people find one direction meaningfully harder than the other.

Someone might lower themselves with control and struggle to rise without pushing off a knee. Split scoring captures that asymmetry rather than averaging it away.

The research behind it

The test was studied in a widely-cited 2014 paper by Brito and colleagues, published in the European Journal of Preventive Cardiology, which followed a large cohort of adults aged 51 to 80 and tracked mortality over the following years. The core finding: each 1-point decrease in sitting-rising test score was associated with a 21% higher risk of all-cause mortality, a hazard ratio of roughly 1.21 per point, an unusually strong, graded relationship for such a simple, quick test.

Adjusted hazard ratios from Brito et al., European Journal of Preventive Cardiology, 2014. Adjusted for age, sex and BMI.

The 5.44 figure belongs to the lowest band alone. Someone scoring 6 or 7 is below 8 and carries a hazard ratio of 1.84, roughly a third of what a single below-8 figure would imply.

The researchers published a comparison of their own in 2025. A low sitting-rising score of 0 to 4, against a perfect 10, carried a 3.8-fold higher risk of natural death, which their secondary analysis found comparable to the 3.4-fold higher risk associated with a history of coronary artery disease, both adjusted for age, sex and BMI.

It's worth being precise about what this kind of finding can and can't establish. As an observational cohort study, it demonstrates a strong association, not proof that improving your score directly causes lower mortality risk, the same underlying factors (strength, mobility, balance, general physical resilience) plausibly drive both the test score and the mortality outcome together. That caveat doesn't undermine the practical value of the test, low functional capacity is worth addressing regardless of the precise causal mechanism, but it's the honest, accurate framing for what this kind of research actually shows.

The 2025 follow-up study

The same research group published a longer analysis in 2025, with a mean follow-up of 12.9 years and 302 deaths, or 9.6% of the cohort. That is roughly double the follow-up and the deaths of the 2014 study.

Death rates across the five score groups, highest to lowest, ran 3.7%, 7.0%, 11.1%, 20.4% and 42.1%.

Comparing the highest against the lowest score groups, adjusted hazard ratios were 3.84 (95% CI 2.25–6.97) for natural mortality and 6.05 (95% CI 2.29–20.94) for cardiovascular mortality. Intermediate scores of 4.5 to 7.5 carried 2.23 and 3.25 increased risk for natural and cardiovascular death respectively.

The cardiovascular confidence interval runs from 2.29 to 20.94. Its width tells you something true about how few events sit behind that estimate.

How the sitting-rising evidence compares to other markers

Brito 2014 followed 2,002 adults aged 51 to 80, 68% of them men, for a median 6.3 years, with 159 deaths. Participants were recruited from a single exercise-medicine clinic in Rio de Janeiro, a self-selected population attending for fitness evaluation.

All published sitting-rising test mortality research comes from the same research group. There is no independent replication by another team in another population.

For comparison, the VO2 Max mortality evidence comes from 122,007 patients with 13,637 deaths, and the grip strength evidence from 139,691 adults across 17 countries.

The app scores a single unbanded threshold because the sitting-rising test measures how much support an individual needs rather than performance against an external standard. Published age- and sex-reference scores do exist for readers who want to see where they sit within their own age group, derived from 6,141 adults by Araújo and colleagues in 2020.

What counts as a good score?

The sitting-rising test is scored out of ten, and the bands below are how the app reads a result.

Hazard ratios from Brito et al., European Journal of Preventive Cardiology, 2014. Adjusted for age, sex and BMI.

Published age- and sex-reference scores derived from 6,141 adults exist for readers who want to see where a score sits within their own age group, from Araújo and colleagues, 2020.

Why the sitting-rising test predicts so much at once

The sitting-rising test doesn't isolate a single quality the way a grip strength or VO2 Max test does. It demands leg strength, particularly quadriceps and glutes, alongside hip and ankle flexibility, balance, coordination and core stability, all at once.

That is likely why it predicts mortality so strongly despite its simplicity. It is a compressed stress test of several capacities that each decline with age and inactivity, captured in one score rather than measured separately.

Quality	Contributes to	Declines most from
Leg strength	Push-off force in both directions	Inactivity, age-related muscle loss
Hip & ankle mobility	Range of motion to reach the floor	Prolonged sitting, limited stretching
Balance & coordination	Stability throughout the movement	Reduced practice, inner-ear changes
Core stability	Trunk control during the transition	General deconditioning

This also mirrors real-world functional demands more directly than many lab-based tests, getting up off the floor, out of a low chair, or off the ground after a fall are genuinely important, unglamorous capabilities tied to independence in daily life, particularly for older adults. A test that closely mimics a real functional task tends to carry more direct relevance to actual quality of life and injury risk than a more abstract, purely diagnostic measurement taken in a lab setting disconnected from anything a person actually does day to day.

A low sitting-rising score may partly be capturing elevated fall risk. That pathway is plausible rather than established. Where it has been tested for a related functional measure it did not hold: the PURE study of 139,691 adults found no significant association between grip strength and injury due to fall, or fracture, despite finding strong associations with all-cause and cardiovascular mortality.

How to take the test safely

Wear clothing that allows a full range of motion, and use a flat, non-slip surface with open space around you.

If you have known balance issues, joint problems, or haven't done a similar movement in a long time, have someone nearby the first time. Trying a cautious version first, with a wall or sturdy furniture within reach even though that isn't part of the official scoring, beats attempting a maximal unsupported effort cold.

The test isn't intended as a maximal-effort athletic performance test, it's meant to reflect your natural, current capability. Attempting it explosively or forcing a faster-than-natural movement in pursuit of a higher score somewhat defeats the purpose and increases injury risk unnecessarily, particularly for anyone who hasn't done functional floor-to-standing movements recently. A controlled, deliberate pace that lets you assess how much support you need is more useful, and safer, than rushing through it.

How to improve your score

Leg strength, particularly in the quadriceps and glutes, directly supports both the lowering and rising phases of the movement. Squats, lunges, and step-ups, performed through a full comfortable range of motion, build the specific strength the test demands, and even bodyweight versions of these movements, done consistently, produce real improvement for most people starting from a deconditioned baseline.

Hip and ankle mobility matter as much as raw strength for many people, particularly those who've spent years in a lot of chair-sitting with limited deep flexion in daily life. Deep squat holds, ankle dorsiflexion stretches, and hip-opener style stretches directly target the ranges of motion the test requires, and limited ankle mobility specifically is an underrated, often-overlooked barrier that shows up clearly the moment someone attempts to lower into a deep squat-like position.

Balance and coordination can be trained somewhat independently of strength and flexibility, through practices like single-leg stands, tai chi, or simply practicing the movement itself slowly and with control, building the motor patterns and proprioceptive awareness the test relies on. These qualities respond well to consistent, low-intensity practice even in people who aren't otherwise doing much structured exercise.

Practicing the movement itself, cautiously and progressively, improves the score directly and fairly quickly. It trains the combination of qualities the test measures together, rather than each in isolation.

Starting from a low baseline, the early gains come fastest, because modest strength and mobility improvements translate directly into needing less support.

Limitations

The test carries real injury risk for very deconditioned people, or anyone with significant joint problems. A maximal unsupported attempt isn't advisable for someone who hasn't done a similar movement in years.

It also isn't diagnostic on its own. A low score suggests reduced functional capacity worth addressing, and it doesn't identify a cause the way a targeted medical assessment would. Someone might score low from a hip mobility restriction, a knee condition, general deconditioning, or several of those together. The test can't tell them apart.

Scoring is somewhat subjective. An observer has to judge what counts as using a hand for support against lightly grazing the floor, so results vary slightly between people scoring the same attempt. The broad categories, no support, one point of support, significant support, are clear and reproducible.

Self-scoring without an observer is common in casual use. Less rigorous than the research version, and still a reasonable signal of change over time.

Common misconceptions

"A low score means I'm going to die soon." The research shows an association with mortality risk over a multi-year follow-up period in a study population, not an individual prediction, and functional capacity is genuinely trainable at essentially any age. A low current score is a signal to act on, not a fixed sentence.

"You need to score a perfect 10 for it to mean anything." Scores of 8-10 were grouped together as the favorable category in the underlying research, a 9 or an 8 reflects a genuinely strong result, not a meaningfully worse outcome than a 10 specifically.

"This test is only relevant for older adults." While the original research studied adults 51-80, the underlying capacities (leg strength, mobility, balance, coordination) matter at every age, and building them earlier in life is part of what determines how gradually or steeply they decline later.

Where it fits with the other functional tests

Most mainstream coverage either ignores functional tests like this one or treats them as interchangeable with everything else. It sits alongside gait speed and single-leg balance as a test you can run at home with nothing but a stopwatch.

It pairs naturally with the ten-second balance test, since one measures leg power and the other measures the stability that power has to work through. A low score on either is worth investigating rather than dismissing.

Mobility work, squats and balance training all improve it directly. If your score is already strong, the useful thing is the trend over years rather than any single result.

Sources

Key references for the claims on this page. Where a figure is attributed to a specific study or body, it is named here.

1. Brito LBB, Ricardo DR, Araújo DSMS, Ramos PS, Myers J, Araújo CGS. Ability to sit and rise from the floor as a predictor of all-cause mortality. European Journal of Preventive Cardiology. 2014;21(7):892–898. DOI · PMID 23242910
2. Araújo CGS, de Souza e Silva CG, Myers J, Laukkanen JA, Ramos PS, Ricardo DR. Sitting–rising test scores predict natural and cardiovascular causes of deaths in middle-aged and older men and women. European Journal of Preventive Cardiology. DOI
3. Araújo CGS, Castro CLB, Franca JFC, Araújo DSMS. Sitting–rising test: sex- and age-reference scores derived from 6141 adults. European Journal of Preventive Cardiology. 2020;27(8):888–890. Sex- and age-reference scores from 6,141 adults.
4. Guralnik JM, Simonsick EM, Ferrucci L, et al. A short physical performance battery assessing lower extremity function. Journal of Gerontology. 1994;49(2):M85–M94. Concerns the timed chair-stand measure, which is a different test from the sitting-rising test. PMID 8126356
5. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis (EWGSOP2). Age and Ageing. 2019;48(1):16–31. Concerns the timed chair-stand measure, which is a different test from the sitting-rising test. DOI

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