The inability to balance on one leg for 10 seconds may be a warning sign


By Donna Fuscaldo,   AARP

An inability to balance for more than 10 seconds on one leg in midlife could be an indicator of early death, according to research published in the British Journal of Sports Medicine. 

It’s widely known that balance diminishes once people reach their mid-50s and beyond, which increases the risk for falls and other incidents that can negatively affect health. Previous studies have linked the inability to stand on one leg to cognitive decline, but little research has been done on the connection between a lack of balance and mortality rates.

A team of Brazilian researchers — led by Claudio Gil Araújo, M.D., of Clinimex, an exercise medicine clinic — set out to see if a simple balance test during a routine physical exam could determine a person’s risk of death from any cause within 10 years.  

Age affects balance 

To test their theory, the researchers turned to the Clinimex exercise cohort study, which was initiated in 1994 to assess physical fitness and cardiovascular risk factors of people living in Brazil. The researchers analyzed 1,702 participants between the ages of 51 and 75, who were asked at their initial checkup to stand on one leg for 10 seconds without any other support. 

To improve standardization, the subjects were told to place the front of the free foot on the back of the opposite lower leg, keep their arms by their side and look straight ahead. The participants (61 years old, on average, and two-thirds of whom were men) were allowed three tries on either foot. One in 5, or 20.5 percent, failed to balance on one leg. Those who couldn’t balance tended to have poorer health; suffer from obesity, heart disease or high blood pressure; and have unhealthy blood-fat profiles.  

By age, the percentage who couldn’t balance was roughly: 

  • 5 percent of those 51 to 55
  • 8 percent of those 56 to 60 
  • 18 percent of those 61 to 65 
  • 37 percent of those 66 to 70 
  • 54 percent of those 71 to 75

Researchers followed up on the participants seven years after the initial checkup and found the following: 

  • 123 people, or 7 percent of the cohort, had died. 
  • 17.5 percent of those who failed the balance test died during the monitoring period, compared with 4.6 percent who were able to maintain balance. 
  • After accounting for age, sex and any underlying conditions, those who could not balance on one leg had an 84 percent increased risk of death from any cause within the next decade.

Can a simple test predict mortality? 

There are limitations to the study, and further research is required. This was an observational study, meaning that researchers haven’t established cause. It also relies on a subject pool of all-white Brazilians and may not apply to other ethnicities and nations.  

Based on their study, the researchers concluded that implementing a simple balance test could provide useful information about mortality risk. “In our 13 years of clinical experience routinely using the 10-s OLS static balance test in adults with a wide age range and diverse clinical conditions, the test has been remarkably safe, well-received by the participants, and importantly, simple to incorporate in our routine practice as it requires less than 1 or 2  min to be applied,” Araújo wrote in the report. “The routine application of a simple and safe static balance test — 10-s OLS — adds useful information regarding mortality risk in middle-aged and older men and women.”

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