Kai DENG
European Journal of Geriatrics and Gerontology - 2026;8(2):66-72
Objective: The tandem stance test (TST) is a simple, non-invasive measure of static balance, but its independent prognostic value for all-cause mortality in the general population remains unclear. This study aimed to evaluate the prospective association between TST performance and all-cause mortality. Materials and Methods: We analyzed data from 11973 participants aged >=45 years (51.8% female; mean age 59.0 +/- 9.2 years) enrolled in the China Health and Retirement Longitudinal Study (CHARLS) at baseline in 2011, with follow-up through 2020. TST was categorized as "success" or "failure". Cox proportional hazards (PHs) models assessed the association between TST outcomes and mortality, adjusting for age, sex, smoking, comorbidities, and income. Sensitivity analyses employed semiparametric PHs models for interval-censored data due to incomplete death dates in some waves. Results: Overall, 22.9% failed the TST; failure was associated with older age, female sex, greater comorbidity burden, and higher mortality (17.8% vs. 11.0%; p < 0.001). In fully adjusted Cox models, TST failure predicted increased mortality risk (hazard ratio (HR): 1.261, 95% confidence interval (CI): 1.128-1.410; p < 0.001). Subgroup analyses showed consistent associations across sex, smoking, comorbidity, and most income strata, but not among participants >=70 years or with high income. Semiparametric models confirmed the robustness of the results (adjusted HR: 1.329, 95% CI: 1.157-1.527; p < 0.001). Conclusion: TST failure is associated with all-cause mortality in middle-aged and older adults. As a quick, scalable tool, TST holds promise for early risk stratification in clinical and public health settings, warranting validation in diverse populations.
