New research from Australia and Brazil has suggested that the inability to stand on one leg for 10 seconds, in mid to later life, can indicate that a person has nearly double the risk of death – from any cause – within the next 10 years.

The findings, published in the British Journal of Sports Medicine, show that after accounting for age, sex, and underlying conditions, the inability to stand on one leg was associated with an 84% heightened risk of death over the next decade.  

Unsurprisingly, the researchers have called for this safe and simple balance test to be included in routine health checks for older adults. 

Lead author, Dr Claudio Gil Araujo from Brazil’s Clinimex Medicina do Exercicio, said that of the 1702 participants, aged 51–75, 123 died during an average monitoring period of seven years: 32% from cancer; 30% from CVD, 9% from respiratory disease, and 7% due to COVID related complications. 

“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%,” Professor Araujo said. 

“[However], in general, those who failed the test had poorer health: a higher proportion were 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%.” 

Australian co-author, Professor Maria Fiatarone Singh from the University of Sydney, explained that information on other potentially influential factors, including recent history of falls, physical activity levels, diet, smoking and the use of drugs that may interfere with balance, was unavailable. 

“Nevertheless, we 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,” Professor Singh said. 

“Unlike aerobic fitness and muscle strength and flexibility, balance tends to be reasonably well preserved until the sixth decade of life, when it starts to wane relatively rapidly. 

“Yet balance assessment isn’t routinely included in health checks of middle-aged and older men and women, possibly because there isn’t any standardised test for it, and there are few hard data linking it to clinical outcomes other than falls.” 

Between February 2009 and December 2020, participants were asked to stand on one leg for 10 seconds without any additional support, placing 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. 

Just over 20% of participants (348) failed to pass the test, with the team observing that the inability to do so rose in tandem with age, almost doubling at subsequent five-year intervals from the age of 51–55 onwards. 

The proportions of those unable to 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 66–70-year-olds. 

More than half (around 54%) of those aged 71–75 were unable to complete the test, meaning that people in this age group were more than 11 times as likely to fail the test as those just 20 years younger.