Surprisingly simple: A simple movement can reveal how at risk we are of falling as we get older – and even indicate our individual risk of death. For the test, 30 seconds are enough, in which we get up from sitting as quickly and often as possible. Using a formula, a value for muscle performance can be determined. If this is below a certain threshold, the risk of older people falling, breaking bones and their consequences increases significantly. A study now reveals how much.
As we age, our muscles become weaker. Cell damage and mutations in muscle cells are no longer repaired as efficiently and the energy supply to the muscles also decreases. As a result, more and more muscle mass is lost over time and muscle strength also decreases. From the age of 60 onwards, the loss of muscle mass due to this sarcopenia is on average 0.5 to one percent per year, and muscle performance even decreases by two to three percent.
As a result, older people are less able to react quickly and effectively to a trip and fall more easily. However, the extent of this age-related muscle loss varies from person to person. For example, the breakdown can be slowed down through targeted muscle training.
This is how the 30 second test works
In order to find out how good your own muscle performance is, researchers led by Julian Alcazar from the University of Castile in Toledo developed a simple test a few years ago: You sit on a chair with your arms crossed in front of your chest and then try to get up as often and quickly as possible within 30 seconds. A formula calculates the number of successful attempts with body weight, sitting height and height. There is now also a free app – PowerFrail – with which you can determine this value yourself.
The result of the stand-up test is the so-called STS value, which indicates muscle performance in watts per kilogram (W/kg). Previous studies have suggested that levels below 2.33 W/kg in men and 2.01 W/kg in women are associated with an increased risk of frailty, problems with everyday activities and falls. “However, it remained unclear whether these limit values are sensitive enough to correctly indicate an increased risk in individual people.
Higher risk of broken bones and hospital stays
Alcazar, his colleague Mikel Garcia-Aguirre and their team have now tested this in a study. To do this, they first determined the individual STS value of 1,876 test subjects over 65 years old using the stand-up test and the formula. They then used the medical data of these people to check whether they had to be treated for falls and broken bones, were hospitalized or even died in the seven following years.
The result: Women with muscle performance below the STS threshold had a 29 percent higher risk of being hospitalized in the following years. The length of their hospital stays was also longer on average. This association was less pronounced in men. However, like the women, they had experienced falls more often in the years before the test, as the researchers report.
Indicator of increased risk of death
“The most astonishing result concerned mortality,” write Garcia-Aguirre and his colleagues. It has been shown that reduced muscle performance in old age also increases the likelihood of premature death – not just as a result of falls or fractures, but regardless of the cause. “Men with low STS levels had a 57 percent higher risk of dying in the following years,” report the researchers. For women, the risk of death was 104 percent higher – more than twice as high as for their peers with normal STS values.
According to Alcazar, Garcia-Aguirre and their team, the simple stand-up test can provide valuable information about how frail and at risk an older person is. “Within just 30 seconds, a movement as simple as standing up can reveal an individual’s risk of falls, hospital stays and even death,” explain the researchers. “Muscle strength is not only essential for maintaining our independence as long as possible as we age, it is also a biomarker for how well we age.”
Source: Mikel Garcia-Aguirre (University of Castilla-La Mancha, Toledo) et al., Journal of Sport and Health Science, 2026; doi: 10.1016/j.jshs.2025.101080