The simple balance test could be useful to include in routine physical exams for people of middle and old age, suggested the research, published Tuesday in the British Journal of Sports Medicine.
While aging leads to a decline in physical fitness, muscle strength and flexibility, balance tends to be reasonably well preserved until age 50, when it begins to decline relatively quickly, the research noted. Previous research has linked the inability to stand on one leg with an increased risk of falls and cognitive decline.
The study involved 1,702 people aged between 51 and 75 years residing in Brazil, who were asked to balance without support on one leg during an initial scan. The researchers told the participants to place the front of the free foot behind the standing leg, keep their arms at their sides, and their eyes fixed ahead. Up to three attempts on each foot were allowed.
Being able to balance on one leg is important to seniors for a number of reasons, and it also reflects broader levels of fitness and health, said study author Dr. Claudio Gil Araújo, from the Exercise Medicine Clinic – CLINIMEX – Rio de Janeiro.
“We regularly need… a one-legged stance, to get out of a car, go up or down a step or ladder, and so on. Not having this skill, or being afraid to do so, is likely related to loss of autonomy and consequently less exercise and the snowball starts,” he explained.
Lack of balance and longevity
Study participants had an average age of 61 years and two-thirds of them were men. About 1 in 5 were unable to balance on one leg for 10 seconds at the initial checkup.
The researchers monitored the participants after the initial check-up for a period of seven years, during which 123 – 7% – of the people studied died. The proportion of deaths among those who failed the test (17.5%) was significantly higher than the deaths among those who managed to balance for 10 seconds (4.5%).
The study found that for those unable to complete the balance test, there was an 84% higher risk of death from any cause, and that link remained even when other factors — including age, sex, BMI, and preexisting conditions or health risks, such as coronary artery disease, hypertension, obesity, high cholesterol and diabetes – were taken into account.
However, the researchers were unable to include in their analysis other variables such as recent history of falls, pattern of physical activity, exercise or sports, diet, smoking and use of medications that may interfere with balance.
The research was observational and does not reveal cause and effect. The study did not look at any possible biological mechanisms that might explain the link between poor balance and longevity.
Dr. Naveed Sattar, professor of metabolic medicine at the University of Glasgow’s Institute of Cardiovascular and Medical Sciences, said the research was interesting but not definitive.
“As a standing leg requires good balance, linked to brain function, good muscle strength and good blood flow, it likely integrates the muscular, vascular and brain systems, so it is a global test of future mortality risk – albeit a crude one.” said Sattar, who was not involved in the study.
“If someone can’t do the 10 seconds and they’re worried, they should reflect on their own health risks,” he said.
“They might try to make positive lifestyle changes like walking more, eating less if they feel they can do better — most underestimate the importance of lifestyle for health,” he said. “But they can also see their doctor if, for example, they don’t have measured risk factors for cardiovascular disease or other chronic conditions like diabetes tested.”
improve balance
In general, those who failed the test were in poorer health and included a higher proportion of people who were obese and/or had heart disease, high blood pressure and unhealthy blood fat profiles, according to the study. Type 2 diabetes was also more common among those who failed to complete the test.
The study took place between 2009 and 2020 and was part of a broader research project that began in 1994.
The inability to complete the balance test increased with age, more or less doubling at subsequent 5-year intervals from the 51-55 age group. More than half (about 54%) of study participants aged 71 to 75 failed to complete the test, compared with 5% in the younger age group who failed to do so.
There were no clear trends in deaths, or differences in causes of death, between those able to complete the test and those who could not.
Araújo said balance can be improved substantially with specific training, and this was something he worked on with patients involved in a physician-supervised exercise program. However, he said he didn’t yet have the data to assess whether improved balance influenced longevity.
If you want to test your own ability to balance on one leg for 10 seconds, Araújo advised that it’s best to stand close to a wall or table or someone else for support.
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