Stair performance in people aged 75 and older.

OBJECTIVES To examine specific behaviors used by older adults while ascending and descending stairs and to assess the relationships between confidence and stair performance. DESIGN Cross-sectional. SETTING Center for Locomotion Studies, The Pennsylvania State University. PARTICIPANTS Sixteen male (mean age=82.7, range= 77-89) and 16 female (mean age=82.2, range=77-87) community-dwelling adults. MEASUREMENTS A stair self-efficacy (SSE) test was created to assess individuals' confidence in their safety on stairs. Observational stair performance measures, measures of walking speed on stairs, and the total SSE score were examined for differences due to sex, and the relationships between SSE and specific stair behaviors were assessed. RESULTS There was a significant relationship between SSE and the safety precautions taken during stair negotiation. Those with lower SSE were more likely to ascend and descend the stairs at a slower speed, use the handrail to a greater extent, and position themselves closer to the rail. The women had lower domain-specific SSE and tended to use the handrail to a greater extent than men even though there were no sex differences in self-reported functional ability or general falls and mobility confidence. A small group of subjects exhibited characteristics of instability, particularly during stair descent, yet most of this group had high SSE scores and failed to use the handrail. CONCLUSION It appears that confidence related to stair negotiation plays a major role in determining risk-taking propensity during stair use in older adults.