Objective: To examine clinical and functional correlates of self-reported difficulty in climbing up or climbing down stairs in older adults.
Design: Cross-sectional survey.
Setting: Community sample.
Participants: Older adults (N=310; mean age, 79.7 y; 62% women), without disability or dementia.
Interventions: Not applicable.
Main outcome measures: Clinical and functional status as well as activity limitations (able to perform activities of daily living [ADLs] with some difficulty).
Results: Of the 310 subjects, 140 reported difficulties in climbing up and 83 in climbing down stairs (59 both). Self-reported difficulty in climbing up stairs was associated with hypertension, arthritis, and depressive symptoms. Difficulty in climbing up stairs was also associated with poor balance and grip strength as well as neurologic gait abnormalities. Subjects with difficulty climbing down stairs had more falls. Both activities were associated with leg claudication, fear of falling, non-neurologic gait abnormalities, and slow gait. Examined individually, self-reported difficulty climbing down stairs captured a wider spectrum of ADL limitations than climbing up stairs. However, combined difficulty in both phases of stair climbing had a stronger association with activity limitations (vs no difficulty; odds ratio, 6.58; 95% confidence interval, 3.35-12.91) than difficulty in any one phase alone.
Conclusions: Self-reported difficulty in climbing up and down stairs revealed commonalities as well as differences in related clinical correlates. Difficulty in both climbing up and down stairs should be separately assessed to better capture clinical and functional status in older adults.