A recent analysis by U.S.-based researchers suggests that combining two noninvasive assessments—a quick waist measurement and a timed chair-rise test—offers surprising accuracy at identifying biological aging and predicting death risk. Easy to perform in a doctor’s office, at home, or even in large-scale screening events, these assessments may soon become standard tools in preventive health checks.
The study focused on two basic metrics: participants’ waist-to-height ratio and their performance on a 5-repetition chair-rise test, which involves standing up and sitting down five times as quickly as possible. Results showed that individuals with a higher waist-to-height ratio, an indicator of abdominal fat, took longer to complete the chair-rise task. This slower performance was consistent even after adjusting for age, gender, and other health variables.
Researchers emphasized that these two measures together can serve as strong indicators of functional aging. The waist-to-height ratio has long been associated with cardiovascular and metabolic risk, while the chair-rise test reflects muscle strength, coordination, and balance—critical functions that decline with age. Their combined use helps paint a more complete picture of biological age than either metric could alone.
The sit-to-stand test, also known as the 5-STS, is widely validated in medical literature as a reliable predictor of mortality. In one large Norwegian cohort study, poor performance on this test was linked to a two- to threefold increase in death risk over five years, surpassing even grip strength in predictive power. By combining that with waist measurements, clinicians can now assess not only current physical health but also estimate future risks more effectively.
These tests are highly practical. Measuring waist-to-height ratio simply requires a tape measure. A value above 0.5 typically indicates higher risk. The chair-rise test involves timing how long a person takes to stand from a seated position and sit back down five times, with scores over 10 to 12 seconds considered below average. The tests can be done in less than five minutes, require no specialized equipment, and can be administered with minimal training.
Functional aging tests like this go beyond laboratory markers. They evaluate real-world capabilities such as mobility, strength, and balance, which correlate with independence and quality of life. Researchers argue that tracking these functions is more relevant to everyday health outcomes than genetic or biochemical markers alone. For instance, recent studies found that movement-based tests predicted long-term survival even when accounting for advanced DNA-based aging measurements.
These tests also offer a motivational benefit. Patients who receive poor scores may be more inclined to adopt healthier behaviors, including exercise, diet, and sleep improvements. Because both waist measurements and chair test results can be rechecked periodically, they provide an effective way to track the success of lifestyle changes.
Clinicians may use the results to determine who requires more comprehensive evaluation. Someone with slow chair-rise times or elevated waist ratios could be flagged for additional screening or earlier intervention. As preventive health models become more personalized, such tools may help direct limited resources where they are most needed.
Experts caution that while these assessments are valuable, they should be interpreted alongside broader health information. A slow chair-rise test might be influenced by temporary factors such as recent injury, fatigue, or joint pain, rather than long-term health decline. Nonetheless, their simplicity, cost-effectiveness, and predictive accuracy make them attractive additions to regular health checkups.
The findings align with a growing movement in healthcare that promotes early, functional assessments as part of routine screenings. As more data emerges to support their use, the waist-to-height ratio and chair-rise combination could become a new standard in identifying individuals at risk of accelerated aging.
By recognizing that aging is a complex, multidimensional process, this approach shifts the focus from isolated biological markers to an integrated view of physical health. It reinforces the value of functional testing in guiding personalized care and preventive strategies that help people age well.
