Neighborhood Deprivation Associated with Impaired Sit-to-Stand Performance in Middle-Aged and Older Adults: A Cross-Sectional Analysis with Clinical Implications

Background: Socioeconomic factors significantly influence health outcomes in older adults, yet their impact on specific aspects of mobility remains unclear. This study investigates the relationship between area-level socioeconomic disadvantage and mobility health in older adults. Methods: We conducted a cross-sectional study of 110 community-dwelling older adults recruited and collected using voluntary response sampling at eight health fairs across rural Southeast Alabama in 2022–2024 (60 ± 16 years, 80% female). Area-level socioeconomic status was measured using the Area Deprivation Index (ADI), a validated composite measure of neighborhood disadvantage. Mobility was assessed using the Instrumented Timed Up and Go (iTUG) test and the Instrumented Five Times Sit-to-Stand (i5TSTS) test. Kruskal–Wallis tests and general linear models in SAS 9.4 analyzed the relationship between ADI and mobility measures. Results: Higher ADI scores were significantly associated with poorer performance on the i5TSTS test (p = 0.0004). While overall iTUG duration did not differ significantly across ADI groups, the sit-to-stand phase of the iTUG showed a significant relationship with ADI (p = 0.0026). These associations remained significant after adjusting for age, weight, race, and education level. Conclusions: These findings suggest that neighborhood context plays a crucial role in mobility health, particularly in functions related to postural transitions. Clinicians should consider area-level disadvantage when screening for mobility limitations and may need to prioritize sit-to-stand interventions for patients living in high-deprivation areas.