Neighborhood deprivation predicts poorer lower-limb strength

By Dr. Sanchari Sinha Dutta, Ph.D.Reviewed by Lauren HardakerJan 6 2026

A new study shows that where older adults live may matter more than age itself when it comes to maintaining the strength needed for everyday movements like standing up, pointing to neighborhood disadvantage as a hidden driver of mobility decline.

Study: Neighborhood Deprivation Associated with Impaired Sit-to-Stand Performance in Middle-Aged and Older Adults: A Cross-Sectional Analysis with Clinical Implications. Image credit: aijiro/Shutterstock.com

A study published in the journal Healthcare links neighborhood socioeconomic deprivation to poorer mobility outcomes in community-dwelling middle-aged and older adults.

Neighbourhood deprivation emerges as a hidden mobility risk

Mobility, defined as the ability of an individual to move safely and independently, is a key determinant of overall well-being in older adults. A gradual decline in mobility with age significantly affects an individual’s ability to perform daily-life activities and engage in social interactions.

Neighborhood-level socioeconomic status is a significant factor influencing mobility. Existing evidence indicates that living in socioeconomically deprived areas increases the risk of various health adversities, chronic diseases, functional disability, and mortality.

Given the increasing socioeconomic health inequalities in recent decades, researchers from Auburn University, USA, conducted a study to explore the relationship between neighborhood-level socioeconomic disadvantages and mobility outcomes in aging populations.

Assessing sit-to-stand and postural transitions

The study included a total of 110 community-dwelling middle-aged and older adults. Participants’ mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and the Instrumented Five Times Sit-to-Stand (i5TSTS) test.

The iTUG test measures postural transitions that are important for daily life activities. Longer time taking during postural transitions is associated with increased risks of falls, disability, and mortality in older adults.

The i5TSTS test measures lower limb strength, which is essential for transitioning from sitting to standing position. A longer time taken during the sitting-to-standing transition is associated with an increased risk of falls and a reduced ability of older adults to independently perform daily life activities.

Neighborhood-level socioeconomic status was measured using the Area Deprivation Index (ADI), which captures various domains of socioeconomic disadvantage, including income, education, employment, and housing conditions within a neighborhood.

Disadvantaged areas show worse sit-to-stand performance

The study found significant variations in lower limb strength and sitting-to-standing transition duration between areas with diverse socioeconomic status. Specifically, participants from more disadvantaged areas exhibited poorer performance in the sitting-to-standing transition test.

Regarding postural transition durations, the study found no significant differences across the ADI groups for overall iTUG duration. However, the sit-to-stand phase of the postural transition test showed a significant association with neighborhood-level socioeconomic disadvantages.

Other iTUG components, such as walking speed and turning, showed no consistent or robust associations with socioeconomic deprivation, although turning performance demonstrated marginal significance in some unadjusted analyses.

New targets for mobility screening and intervention

The study reveals that older adults from socioeconomically deprived areas experience significantly reduced lower limb strength and function. A similar negative impact of area-level socioeconomic disadvantage has been observed on the ability of older adults to rise from a seated position (sit-to-stand phase).

The observed selective impact on the sit-to-stand phase of postural transitions, which primarily depends on the lower limb strength, highlights condition-specific susceptibility of older adults to logistic, capital, and other resources that characterize disadvantaged neighborhoods.

Regarding other phases of postural transitions, such as walking speed and turning, the study did not find a consistent, adjusted, significant impact of socioeconomic disadvantages. This finding suggests that these postural aspects may be more resilient to neighborhood-level influences or rely on different physiological systems.

Overall, these observations indicate that socioeconomic deprivation of a given region does not affect all mobility domains equally. Instead, it has a direct influence on muscle-dependent postural transitions.

Multiple factors related to socioeconomic disadvantage, including lack of physical activity resources, nutritional inadequacies, chronic stress, and inaccessibility to the healthcare system, can collectively contribute to the observed reduction in mobility outcomes.

The lack of safe walking paths, adequate lighting, and age-appropriate exercise equipment can potentially restrict older adults from regularly performing walking or other outdoor exercises. Limited transportation access further restricts their ability to reach available resources. Such physical inactivity can contribute to observed disparities in sit-to-stand performance.      

Similarly, nutritional deprivation, such as inaccessibility to affordable, nutrient-dense foods and the easy availability of fast-food outlets and convenience stores, can lead to protein, vitamin, and mineral deficiencies, resulting in the deterioration of muscle mass, strength, and function.

Socioeconomic deprivation is frequently associated with chronic health conditions, such as hypertension, diabetes, obesity, arthritis, and cardiovascular disease. All these diseases can potentially impair muscle functions and reduce mobility, especially in sit-to-stand movements. These chronic conditions require regular medical care, which is also inaccessible or available in poor quality in socioeconomically deprived areas, further deteriorating mobility outcomes.

Overall, the study observations have implications for developing targeted interventions, such as sit-to-stand interventions. Implementing mobility screening at community health fairs and primary care clinics in socioeconomically disadvantaged areas would be helpful in identifying at-risk populations.

Prioritizing investments for developing infrastructure in deprived areas, such as outdoor fitness equipment, benches, and safe walking paths, would be another strategy to improve mobility and overall well-being in older adults.

Due to the cross-sectional design, the study was unable to determine the causality of the observed associations. It remains uncertain whether the observed reduction in mobility outcomes is caused by current neighborhood conditions or due to long-term exposure to disadvantaged environments. Future research tracking changes in both neighborhood characteristics and mobility measures over time would provide stronger evidence for causal associations.

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