| dc.description.abstract | Background: Understanding health inequalities among older adults is important as Canada’s population ages. Health outcomes and health inequalities deteriorate with age, with income-related heath inequalities in Canada worsening in recent decades. Individuals in the lowest socioeconomic positions have the poorest health outcomes, and health outcomes improve in a stepwise fashion among those with higher socioeconomic positions – this is known as the socioeconomic gradient of health. Objective measures of health, including physical capability measures such as the chair rise test, which correlates with future health outcomes and other health measures, may be a vital addition in studies of aging and health inequality in older populations.
Objectives: The overall goal of this project is to explore the use of the chair rise test as a measure of intrinsic capacity (i.e., all physical and mental capacities of an individual without supportive environments) in health inequality studies among older adults. The specific objectives of this project are to: (1) explore differences in the chair rise test across demographic, behavioural and socioeconomic factors, (2) assess associations between the chair rise test and other measures of health, (3) investigate the presence of a socioeconomic gradient in the chair rise test, (4) if the socioeconomic gradient exists in the chair rise test, investigate how it differs by age and sex.
Methods: We used the most recently available, first follow-up data from the Canadian Longitudinal Study on Aging (CSLA) Comprehensive Cohort. Our sample included 24,685 observations (52.6% female, average age 65.1 years, Standard Deviation (SD) = 9.9) who completed both computer-assisted interviews and clinical and physical examinations, including physical capability tests. We created two dependent variables for the chair rise test: chair rise test time and chair rise test ability. We conducted a series of ordinary least squares regression models to assess associations between the chair rise test and other health measures, and socioeconomic (income, education, and wealth), demographic, and health behaviour variables. Additionally, we ran a series of logistic regression models to determine if there was any association between chair rise test ability and the dimensions of health and socioeconomic status variables. We arranged a series of stakeholder consultations with older adults and healthcare workers, and they provided insight into the usefulness of this measure and input on knowledge translation strategies.
Results: 1,288 (5.2%) of the participants in the analytical sample were unable to complete the chair rise test. Of the 23,397 (94.8%) participants who were able to complete the chair rise test, the average time was 12.53 seconds (SD = 3.5). The chair rise test was statistically and clinically, in a predicted manner, associated with all measures of health we assessed. There was a statistically significant and clinically meaningful difference in chair rise test times between the highest and the lowest income groups.
Policy Implications: The chair rise test is an easy to assess, important movement for day-to-day activities, making it a promising objective measure for future research, clinical practices, and population-based studies. | en_US |
