Factors Influencing Longitudinal Stair Climb Performance from Midlife to Early Late Life: The Study of Women’s Health Across the Nation Chicago and Michigan Sites

  • Brittney S. Lange-MaiaEmail author
  • C. A. Karvonen-Gutierrez
  • E. S. Strotmeyer
  • E. F. Avery
  • B. M. Appelhans
  • S. L. Fitzpatrick
  • I. Janssen
  • S. A. Dugan
  • H. M. Kravitz



To quantify the longitudinal change in stair climb performance (a measure indicative of both physical function and muscle power), determine whether physical activity is related to slower decline in performance, and to identify factors that modify the longitudinal change in performance among women from midlife to late life.


Longitudinal cohort study with up to 15 study visits.


Two sites of the Study of Women’s Health Across the Nation.


Black (n=411) and white (N=419) women followed from median age 47.0 (44.6–49.6) to 62.0 (55.8–65.3) years.




Performance on a stair climb test (ascend/descend 4 steps, 3 cycles) was timed. Physical activity (PA) was assessed using the Kaiser Physical Activity Survey (KPAS; possible range 0–15 points). Sociodemographic and health factors were assessed via self-report. BMI was calculated with measured height and weight. Mixed-effects regression modeled longitudinal change in stair climb performance.


Average baseline stair climb time was 18.12 seconds (95% CI: 17.83–18.41), with 0.98% (95% CI: 0.84%–1.11%) annual slowing. In fully adjusted models, higher levels of PA were associated with faster stair climb times (2.09% faster per point higher, 95% CI: −2.87%–1.30%), and black women had 5.22% (95% CI: 2.43%–8.01%) slower performance compared to white women. Smoking, financial strain, diabetes, osteoarthritis, fair/poor health, and stroke were associated with 3.36% (95% CI: 0.07%–6.65%), 7.56% (95% CI: 4.75%–10.37%), 8.40% (95% CI: 2.89%–13.92%), 8.46% (95% CI: 5.12%–11.79%), 9.16% (95% CI: 4.72%–13.60%), and 16.94% (95% CI: 5.37%–28.51%) slower performance, respectively. In separate models, higher BMI (per 1-unit), osteoarthritis, fair/poor health, and diabetes, were each associated with 0.06% (95% CI:0.04%–0.08%), 0.48% (95% CI:0.12%–0.84%), 0.81% (95% CI:0.35%–1.28%), and 0.84% (95% CI:0.22%–1.46%), additional slowing per year over time.


Significant declines in function were evident as women transitioned from midlife to early late life. Declines were amplified by indicators of poor health, emphasizing the importance of health in midlife for promoting healthy aging.

Key words

Physical function aging midlife women 


Acknowledgments: The Study of Women’s Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women’s Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH or the NIH. Clinical Centers: University of Michigan, Ann Arbor — Siobán Harlow, PI 2011–present, MaryFran Sowers, PI 1994–2011; Massachusetts General Hospital, Boston, MA — Joel Finkelstein, PI 1999–present; Robert Neer, PI 1994–1999; Rush University, Rush University Medical Center, Chicago, IL — Howard Kravitz, PI 2009–present; Lynda Powell, PI 1994–2009; University of California, Davis/Kaiser — Ellen Gold, PI; University of California, Los Angeles — Gail Greendale, PI; Albert Einstein College of Medicine, Bronx, NY — Carol Derby, PI 2011–present, Rachel Wildman, PI 2010–2011; Nanette Santoro, PI 2004–2010; University of Medicine and Dentistry — New Jersey Medical School, Newark — Gerson Weiss, PI 1994–2004; and the University of Pittsburgh, Pittsburgh, PA–Karen Matthews, PI. NIH Program Office: National Institute on Aging, Bethesda, MD–Chhanda Dutta 2016–present; Winifred Rossi 2012–2016; Sherry Sherman 1994–2012; Marcia Ory 1994–2001; National Institute of Nursing Research, Bethesda, MD — Program Officers. Central Laboratory: University of Michigan, Ann Arbor — Daniel McConnell (Central Ligand Assay Satellite Services). Coordinating Center: University of Pittsburgh, Pittsburgh, PA — Maria Mori Brooks, PI 2012–present; Kim Sutton-Tyrrell, PI 2001–2012; New England Research Institutes, Watertown, MA — Sonja McKinlay, PI 1995–2001. Steering Committee: Susan Johnson, Current Chair, Chris Gallagher, Former Chair. We thank the study staff at each site and all the women who participated in SWAN.


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Copyright information

© Serdi and Springer-Verlag International SAS, part of Springer Nature 2019

Authors and Affiliations

  • Brittney S. Lange-Maia
    • 1
    • 2
    • 8
    Email author
  • C. A. Karvonen-Gutierrez
    • 3
  • E. S. Strotmeyer
    • 4
  • E. F. Avery
    • 1
    • 2
  • B. M. Appelhans
    • 1
  • S. L. Fitzpatrick
    • 5
  • I. Janssen
    • 1
  • S. A. Dugan
    • 6
  • H. M. Kravitz
    • 1
    • 7
  1. 1.Department of Preventive MedicineRush University Medical CenterChicagoUSA
  2. 2.Center for Community Health EquityRush University Medical CenterChicagoUSA
  3. 3.Department of Epidemiology, School of Public HealthUniversity of MichiganAnn ArborUSA
  4. 4.Department of Epidemiology, Graduate School of Public HealthUniversity of PittsburghPittsburghUSA
  5. 5.Kaiser Permanente Center for Health ResearchPortlandUSA
  6. 6.Department of Physical Medicine & RehabilitationRush University Medical CenterChicagoUSA
  7. 7.Department of PsychiatryRush University Medical CenterChicagoUSA
  8. 8.ChicagoUSA

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