Standing on one leg may indicate how long you will live

Inability to balance for 10 seconds in mid to later life linked to near doubling in risk of death

Unlike aerobic fitness, muscle strength and flexibility, balance tends to be reasonably well preserved until the sixth decade of life. Getty Images

A flamingo-style balance test should be introduced in routine health checks for older adults as it could be a key indicator of how long you will live, researchers say.

The inability to stand on one leg for 10 seconds in mid to later life is linked to a near doubling in the risk of death from any cause within the next 10 years, a study has suggested. A fifth of those studied failed the test.

Unlike aerobic fitness, muscle strength and flexibility, balance tends to be reasonably well preserved until the sixth decade of life, when it starts to wane relatively rapidly, note the researchers in the study published online in the British Journal of Sports Medicine.

The researchers concluded that the 10-second balance test “provides rapid and objective feedback for the patient and health professionals regarding static balance” and that the test “adds useful information regarding mortality risk in middle-aged and older men and women”.

Ten years ago, the team showed that the ability to sit and rise from the floor was strongly associated with survival.

Yet balance assessment is not routinely included in health checks of middle-aged and older men and women, possibly because there is no standardised test, with a lack of hard data linking it to clinical outcomes other than falls, they said.

They analysed statistics in an almost 30-year exercise study in Brazil, which compared physical fitness and conventional cardiovascular risk factors, with ill health and death.

Claudio Gil Araujo, physician and dean of research and education at the Exercise Medicine Clinic in Rio de Janeiro in Brazil, told The National: “All three components of nonaerobic physical fitness — muscle strength/power, flexibility and balance — are potentially relevant for good health and, even more relevant, for survival in older subjects.”

As part of the check-up, participants were asked to stand on one leg for 10 seconds without additional support.

They were asked to place the front of the free foot on the back of the opposite lower leg, while keeping their arms by their sides and their gaze fixed straight ahead. Up to three attempts on either foot were permitted.

About one in five (20.5%) of the 1,702 participants aged 51–75 failed the test. The inability to do so rose in tandem with age, more or less doubling at subsequent five-year intervals from the age of 51–55 onwards.

The proportions of those who failed were: nearly 5 per cent of 51–55 year olds; 8 per cent of 56–60 year olds; slightly fewer than 18 per cent of 61–65 year olds; and slightly fewer than 37 per cent of 66–70 year olds.

More than half (around 54 per cent) of those aged 71–75 were unable to complete the test, making them 11 times as likely to fail as those 20 years younger. Dr Araujo suggested a few minutes practising each day could significantly improve balance.

During an average monitoring period of seven years, 123 people died from causes such as cancer, cardiovascular disease, respiratory disease and Covid-19 complications.

The proportion of deaths among those who failed the test was significantly higher: 17.5 per cent compared with 4.5 per cent.

Those who failed the test had poorer health in general: a higher proportion were obese, and/or had heart disease, high blood pressure and unhealthy blood fat profiles. Type 2 diabetes was three times as common.

After accounting for age, sex, and underlying conditions, an inability to stand unsupported on one leg for 10 seconds was associated with an 84 per cent heightened risk of death from any cause within the next decade.

Dr Araujo said: “Being very practical and pragmatic, physical fitness is so relevant to health, quality of life and survival that it should be assessed in every medical or health check and could be easily performed together with the measurements of height, weight and blood pressure.

“Poor nonaerobic fitness (normally associated with a sedentary lifestyle, but not always) is the background of most cases of frailty.”

He said that older people falling and suffering major fractures may play a role in this higher mortality.

“Also remember that we regularly need to stay in a one-legged posture, to move out of a car, to climb or to descend a step or stair and so on.”

The researchers point out that as an observational study, it cannot establish cause. As participants were all white Brazilians, the findings might not be more widely applicable to other ethnicities and nations, they said.