This simple 10-second balance test can show if your risk of death is double

Balancing on one leg

According to new research published in the British Journal of Sports Medicinethe inability to stand on one leg for 10 seconds is associated with almost a double risk of dying over the next 10 years.

The inability to stand on one leg for 10 seconds in mid-life is associated with a nearly doubling of the risk of death.

Nearly doubling the chance of dying from any cause over the next 10 years is associated with the inability to stand on one leg for 10 seconds in mid to late life. This is according to new research results published on June 21, 2022 in the British Journal of Sports Medicine.

According to the researchers, this simple and safe balance test could be incorporated into routine health checkups for older adults.

Balance typically remains quite well preserved until the sixth decade of life, when it begins to deteriorate relatively quickly, the researchers say, unlike aerobic fitness, muscle strength and flexibility.

However, balance assessment is not routinely included in health checks of middle-aged and older men and women. This may be because there is no standardized test for it and there is little hard data linking balance to clinical outcomes other than falls.

The scientists therefore wanted to know whether a balance test could be a reliable indicator of a person’s risk of death from any cause within the next decade, and as such could be included in routine health checks later in life.

The researchers draw from participants in the CLINIMEX Exercise cohort study. This was set up in 1994 to assess associations between different measures of physical fitness, exercise-related variables, and conventional cardiovascular risk factors, with ill health and death.

The current analysis included 1702 participants aged 51-75 (mean 61) at their first checkup, between February 2009 and December 2020. About two-thirds (68%) were male.

Weight and various measures of skinfold thickness plus waist circumference were taken. Details of medical history were also provided. Only those with a stable gait were included.

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

To improve the standardization of the test, participants were asked to place the front of the free foot on the back of the opposite lower leg, keeping their arms at their sides and looking straight ahead. A maximum of three attempts on both feet were allowed.

Overall, about 1 in 5 (20.5%; 348) participants failed the test. The inability to do this increased with age, more or less doubling at 5-year intervals from age 51-55.

The proportions of those who could not stand on one leg for 10 seconds were: nearly 5% among 51-55 year olds; 8% among 56-60 year olds; just under 18% among 61-65 year olds; and just under 37% among 66- to 70-year-olds.

More than half (about 54%) of 71- to 75-year-olds failed to complete the test. In other words, people in this age group were more than 11 times more likely to fail the test than those who were just 20 years younger.

During an average monitoring period of 7 years, 123 (7%) people died: cancer (32%); cardiovascular disease (30%). respiratory disease (9%); and[{” attribute=””>COVID-19 complications (7%).

There were no clear temporal trends in the deaths, or differences in the causes, between those able to complete the test and those who weren’t able to do so.

But the proportion of deaths among those who failed the test was significantly higher: 17.5% vs 4.5%, reflecting an absolute difference of just under 13%.

In general, those who failed the test had poorer health: a higher proportion was obese, and/or had heart disease, high blood pressure, and unhealthy blood fat profiles. And type 2 diabetes was 3 times as common in this group: 38% vs around 13%.

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

This is an observational study, and as such, can’t establish cause. As participants were all white Brazilians, the findings might not be more widely applicable to other ethnicities and nations, caution the researchers.

And information on potentially influential factors, including recent history of falls, physical activity levels, diet, smoking, and the use of drugs that may interfere with balance, wasn’t available.

Nevertheless, the researchers conclude 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.”

Reference: “Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals” by Claudio Gil Araujo, Christina Grüne de Souza e Silva, Jari Antero Laukkanen, Maria Fiatarone Singh, Setor Kwadzo Kunutsor, Jonathan Myers, João Felipe Franca and Claudia Lucia Castro, 21 June 2022, British Journal of Sports Medicine.
DOI: 10.1136/bjsports-2021-105360

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