You may have heard about the Sitting-Rising Test for Mortality. This test is said to predict your mortality based on how well you perform the task of sitting down onto the floor and rising back up to standing. I’ve seen news articles and video segments about this test passed around an abundance of times on social media with headlines like “Simple Sitting Test Predicts How Long You’ll Live” and “The Exercise That Predicts Your DEATH”. (Scary!)
Now I am definitely a proponent of the importance of skill in functional movements like sitting and rising from the floor, and I teach yoga and movement with this as a guiding principle. But I was curious about the bold claims and dire warnings I was seeing associated with this sitting-rising test, and I also didn’t love the idea of someone scoring a point or two below perfect on the test and then worrying that certain death was nearly upon them. I decided to examine the original research study on the sitting-rising test to find out what the researchers actually did and what their results truly suggested. I discovered that the research does show that this test can be a helpful assessment tool for a small percentage of the population (namely elderly people), but that the study’s results have been largely misinterpreted by news articles and the health and fitness world in general.
WHAT IS THE SITTING-RISING TEST?
For those not familiar with the sitting-rising test, it’s very simple to perform. From standing, lower yourself into a seat on the floor and then rise back up again to standing, using the minimum amount of support that you can (i.e. try not to use your hands or knees to help you.) You’re awarded 5 points if you can sit down without support and 5 more points if you can stand without support for a total possible score of 10. For each hand, knee, or other form of support that you use on the way down and up, 1 point is deducted from your score.
According to the study, lower sitting-rising scores were associated with higher mortality among its subjects. This seems quite suggestive on the surface, but let’s examine a few details about the study that are often overlooked in news and media reports.
1) The title of the study, “Ability to sit and rise from the floor as a predictor of all-cause mortality”, is very easy to misinterpret. To most of us, the term “all-cause mortality” is foreboding and seems to suggest that if you score lower on the test, you have an increased risk of dying from all possible causes - i.e. cancer, heart disease, stroke, diabetes, etc. How worrisome indeed! But what this term truly means is that the researchers did not control for type of mortality in their study because they did not know how their subjects died. This is actually the exact opposite of the way that most readers would interpret the meaning of the title.
Because the study did not control for type of mortality, and because the sitting-rising test assesses musculoskeletal health qualities like balance and strength, the most likely explanation for the deaths reported was that they were from falls. Therefore a lower score on the sitting-rising test probably does not suggest that you might die sooner from cancer, heart disease, diabetes, or a host of other frightening possibilities. A lower score instead probably simply suggests that you lack balance and strength skills, which indicates that you’re more likely to take a fall. We know that falls are an unfortunately common cause of death among older populations, which leads us right into the next point:
2) The majority of people who received low scores on the sitting-rising test were between the ages of 76-80. And the study itself also only looked at people between the ages of 51-80. This means that the sitting-rising test was most meaningful for elderly people (and again, this could be explained in large part because of the high incidence of falling as a cause of death among the elderly.) This also means that despite news reports that this “simple test predicts how long you’ll live”, if you are younger than 51 years of age, the results of this study do not actually apply to you.
3) The study showed no difference in mortality between those who scored an 8, 9, and a 10 on the test. This means that if you use one hand for support on the way down to your seat and one hand on the way back up (a score of 8), your mortality risk is no different from someone who uses no support at all and scores a perfect 10. This seems counterintuitive and is not the way the sitting-rising test is generally presented to us in the health and fitness world. We are usually told that using one or two hands and knees is significantly worse than using no hands or knees at all. But this is a misinterpretation of what the study found.
4) The magnitude of the effect becomes most worrisome at scores lower than 6 (using 5 or more hands and knees), and is largest with a score of 3 or less (7 or more hands and knees). And because the majority of people who received these low scores were elderly, the effect is really much more relevant for this age demographic (and is likely explained by falls.) This isn’t to say that this test is meaningless for people in their early 50’s. But in all likelihood, if a 51-year old has to use 7 or more hands and knees to lower to the floor and rise back up (just picture for a moment what that would like), this is probably indicative of obesity or some other fairly obvious health factor that is impeding their function and affecting their mortality that this study did not control for. (While the researchers did control for body mass index, this is not the same as controlling for obesity.)
In conclusion, I definitely believe there is value in learning to sit and stand with as little support as possible, and I do teach this skill in my yoga and movement classes. But unless better research comes out in the future, I would hesitate to suggest based on this study that people should assess their own mortality by using the “sitting-rising test”. I believe that doing so could cultivate unnecessary fear, stress, and discouragement in people who don’t score a perfect 10, and it could also encourage a false sense of security in people who do. This test appears to be statistically significant for elderly people only, and even then, the mortality likelihood predicted could be driven entirely by falls. The “sitting-rising” test is probably best utilized by medical doctors as a general screening tool for their patients in combination with other routine health assessments like measuring blood pressure and taking pulses.