Locomotion on stairs is among the most challenging and hazardous activities
of daily living for older individuals. This is evidenced by the reports th
at stair falls account for more than 10% of fatal fall accidents. The deman
ds that stairs place on the musculoskeletal and cardiovascular systems are
compounded by the need for input from the somatosensory, visual, and vestib
ular systems at various stages in the task. Many of these collaborating sys
tems deteriorate with aging, thus increasing the difficulty and risk of fai
lure in a task that inherently involves exposure to significant danger. The
task itself varies in its degree of challenge depending on many structural
and environmental factors that are outside the control of the stair user.
This review explores existing literature in the area of stair negotiation b
y older persons in an effort to define the key factors associated with diff
iculty and safety on stairs and to interpret these findings in the light of
possible interventions that could increase stair safety. Further research
is needed to ensure that current recommendations for stair design are suita
ble for older stair users. A Glossary of Terms is also provided.