Should You Take Stock in Longevity Tests?
If you ride regularly, the concept of longevity probably factors into your life. After all, you need to stay in good shape to keep riding your bike into your golden years. To get a picture of your baseline health and some insight into how long you’ll live, you might have seen longevity tests floating around the internet touting a simple single-leg balance or standing up from the ground as a marker of your biological age. But do these tests really give you a clear view of your health and your lifespan?
“There are so many different types of tests that measure longevity, predict mortality, or risk of falls,” says Kimberly Esposito, M.P.T., and board-certified geriatric clinical specialist and physical therapist at The Johns Hopkins Hospital in Baltimore. In most cases, you’d work with a healthcare professional to get insights into your strength and balance, as well as frailty or mortality, from these tests. But many people may attempt a longevity test at home to see if they’re physically healthy for their age.
To get to the bottom of these tests, we asked medical experts to share commonly used longevity tests and break down what these assessments actually tell us. Plus, what to look for should you attempt them.
5 Common Longevity Tests
1. Sit-to-Rise Test
How to do it: The objective is to transition from standing to sitting on the floor and back to standing again without any help from your hands. To do it:
Start standing.
Sit on the floor with legs crossed, without using hands.
Stand back up, without putting your hands on the ground.
You get five points if you can sit down from standing without using your hands, and then another five points if you can stand up in the same way—without using your hands or elbows. Ten is a perfect score. Subtract a point every time you use your hand, knee, forearm, or side of your leg to help.
What it looks at: Your ability to get up from the floor, just using your legs.
A landmark study published in the European Journal of Preventive Cardiology found that an older person’s ability to complete this test—sit and stand from the floor—was an accurate predictor of mortality. The study assessed more than 2,000 adults, who ranged from 51 to 80 years old.
But the study doesn’t tell the whole story. Esposito points out that the subjects tested did not have any musculoskeletal injury, like an arthritic knee, recent surgery, or pre-existing conditions. “This test is not typically used in the clinic to measure frailty or mortality,” Esposito says, because if you injured your knee in the past, you may not be able to do the test thanks to the mobility it requires. If you recently had chemo and have neuropathy (numbness or tingling in the hands and feet), you may also not be able to perform this test.
In other words, keep in mind that if you can’t do the sit to rise longevity test, it doesn’t mean you don’t have an optimal life expectancy—the study just didn’t take into account some preexisting conditions that could prevent you from scoring well.
What’s more: While this test (and all longevity tests) may indicate where you’re at for your current age, they really can’t tell you how much longer you’re going to live, says Richard Dupree, M.D., chief of geriatrics at Tufts Medical Center in Boston. So if you can complete it easily now, it isn’t necessarily a free pass to living a long life.
2. Five-Time Sit-to-Stand Test
How to do it: The five-time sit-to-stand test is performed by a person sitting in a standard chair with their arms placed across their body, and then standing up and sitting down five times.
What it looks at: If you can’t complete the test in under 15 seconds, you have an increased risk of frailty, falls, and therefore increased risk of mortality, Esposito says.
“This is a really good test at measuring strength and balance and predicting risk of falls in our patients,” Esposito says.
A recent review published in Biology, which looked at eight different studies, found that the sit-to-stand test (getting up from a chair—not the floor like the sit-to-rise test) is an accurate measure of lower limbs muscle strength and balance, regardless of whether subjects are healthy or diagnosed with diseases like hip osteoarthritis, chronic obstructive pulmonary disease, stroke, or Parkinson’s disease. Overall, researchers found that this longevity test is a reliable tool for measuring dynamic balance and functional mobility.
Some factors, like arthritis of the knee, may still limit your ability to complete this test without indicating you have a high fall risk, though, Esposito says.
3. Timed Get-Up-and-Go Test
How to do it: Sit back in a standard arm chair and identify a line 10 feet away (or 3 meters) on the floor. Have someone time you, and on the word “Go,” begin timing. Stop timing after you walk the 10 feet and then walk back to sit back down.
What it looks at: An older adult who takes longer than 12 seconds to complete the timed get-up-and-go (or TUG) test is at a higher risk for falling.
TUG examines overall physical performance, ability to stand up and sit down, walking speed, and ability to balance, so healthcare providers can get a lot of important information based on their patients’ performance from this test.
If you can get up without pushing yourself off from a chair and complete the test in under 12 seconds it tells us two things: you have good quad strength and balance, which are important to prevent falling, Dupree says.
Research supports the efficacy of this test. A research review published in BMC Geriatrics, which involved 2,314 patients from 10 studies, all aged 65 and older, found that a TUG score of 13.5 seconds or longer was predictive of a falling risk. In comparison, a TUG score of less than 13.5 seconds denotes stronger functional performance.
4. Gait Speed Test
How to do it: This test is based on walking speed: If you can walk faster than 2.2 miles per hour (about a 27-minute mile) you have an average life expectancy.
What it looks at: This longevity test examines walking speed.
How quickly you walk is an assessment of your overall health picture, as a slow walking speed is a marker for frailty. The gait speed test is widely recognized, researched, and used by healthcare professionals to measure a patient’s normal pace.
A meta-analysis published in the Journal of the American Medical Directors Association found that a slow gait meant a higher risk of poor cardiovascular health, cancer, and premature mortality.
There are age and gender standards for this test but, “people who are 65 years and older and walk greater than one meter per second, tend to live longer and have fewer falls,” Esposito says.
Dupree agrees that assessing a patient’s gait speed is important as it’s a common measure of frailty, a marker of your current fitness, and if you can walk faster than the 2.2 miles per hour, you may have a higher chance of living longer.
5. Grip Strength Test
How to do it: Typically a physical or occupational therapist will perform this test and measure how well you can grip a hand dynamometer. You’ll grip the instrument three times as hard as you can in each hand and a health care professional will assess your strength.
What it looks at: This longevity test focuses on hand and forearm strength.
Grip strength—how well you can grip with either hand—is measured by a healthcare professional with a hand dynamometer, which is a handheld device that measures the force your muscles create. You might have this test done if you notice your grip strength is changing with age, like if you are having trouble opening jars or are frequently dropping items.
The good news: You can easily improve grip strength at home by purchasing a dynamometer or doing specific grip-strengthening exercises, like farmer’s walks. (You can also visit the NIH website to see demonstrations on how to properly measure your grip strength.)
Research published in Clinical Interventions in Aging suggests that poor grip strength is a marker for increased risk of cardiovascular disease, cancer, and mortality. According to the study, poor grip strength is often seen as a marker for poor overall strength, upper limb function, bone mineral density, and can be a marker for a person’s likelihood to have an increase of fractures, falls, malnutrition, cognitive impairment, depression, sleep problems, diabetes, and quality of life.
“Poor grip strength is a predictor of frailty because grip strength is a predictive biomarker that correlates with decreased strength, function, health status and mortality,” Esposito adds.
Some studies even suggest that poor grip strength could be indicative of cognitive impairment, like dementia, Dupree says.
The Bottom Line: Know the Frailty Markers and How to Protect Yourself
According to the CDC, falls are the leading cause of fatalities and non-fatal injuries for older Americans, and more than one in four Americans who are 65 and older fall each year. If you notice you have one of these markers listed, talk to your doctor.
The five predictors of frailty, according to Esposito:
Poor grip strength
Slow walking speed
Low physical activity level
Self reports of exhaustion
Unintentional weight loss
Dupree cautions that with aging the ability to balance is one of the first things you lose, which is a normal part of aging, but there are ways to protect yourself, including staying physically active and regularly doing muscle-strengthening workouts. Dupree advises seniors get involved in activities that maintain their balance, and specifically recommends Tai Chi.
Research backs up Tai Chi’s effectiveness for seniors, as well. In 2023, Frontiers in Public Health published a meta-analysis illustrating that Tai Chi is effective for healthy older adults, and those at risk of falling for improving balance and preventing falls.
In addition to working on balance, Dupree says to continue to work on muscle-strengthening exercises for the rest of your life, “for reasons primarily to protect yourself from cognitive loss, as well as protect yourself from cardiovascular disease, and protect yourself from falling,” he says.
So whether you’re at an age where you’re at increased risk of falling or not, it’s important to work to maintain mobility and functional movement as you age. And longevity tests can be a tool to help you gauge your fitness in the moment and identify areas (like balance and grip strength) that you can work on to maintain an active lifestyle—something all cyclists should appreciate!
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