Can Difficulty Standing from a Chair Signal Early Risk of Chronic Illness? Insights from a Multi-Wave European Cohort

Background: Difficulty rising from a chair may indicate early functional decline and vulnerability to adverse health outcomes. While widely used in geriatric assessments, its role in predicting diverse health domains using large-scale longitudinal data remains underexplored. Methods: We analysed 52,541 adults aged ≥ 50 years from the Survey of Health, Ageing and Retirement in Europe (SHARE), Waves 5–9 (2013–2022). Chair-rise difficulty was assessed at baseline using a single self-reported item: “Getting up from a chair after sitting for long periods.” Responses were dichotomized (0 = no difficulty, 1 = difficulty). Incident outcomes included musculoskeletal, cardiometabolic, cardiovascular, neurological, and psychosocial conditions, as well as low handgrip strength (HGS) and low quality of life (QoL). Logistic regression models estimated odds ratios (OR) adjusted for baseline comorbidity, BMI, age, sex, and country. Results: At baseline, 18.6% reported chair-rise difficulty. Adjusted models showed higher odds of low QoL (OR 1.46, 95% CI 1.28–1.64), elevated depressive symptoms (OR 1.27, 1.12–1.43), and osteoarthritis (OR 1.25, 1.12–1.38). Associations with HGS and rheumatoid arthritis were small and imprecise. Cardiometabolic and vascular outcomes were attenuated or inversely associated after adjustment (e.g., hypertension: OR 0.47; diabetes: OR 0.64). Alzheimer’s disease and stroke showed no clear association. Conclusion: Self-reported chair-rise difficulty is a simple, scalable indicator of psychosocial burden and musculoskeletal morbidity in older adults. Its feasibility for extensive surveys supports its use in population-level screening, although associations with cardiometabolic outcomes require cautious interpretation.