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If You Can Stand on One Foot, You Might Live Longer

Over 80 percent of test subjects bore out the hypothesis.

Key points

  • A recent study linked the ability to balance while standing on one foot with life expectancy.
  • In the study, age had a significant effect on the ability to hold the one-leg position.
  • The authors suggest that the test should be incorporated into standard health exams as a starting point for investigating underlying disorders.

The next time you have to wait in line, say at an airport check-in counter, you could pass the time, at least a few seconds of it, by standing on one foot. And if you are able to balance for at least 10 seconds with one foot touching the mid-calf of the other, you may have an indication as to your life expectancy. At least this is the finding of a large study reported recently in the British Journal of Sports Medicine.

The researchers point out that balancing ourselves when we stand or walk is something most of us can do reasonably well until we reach our sixth decade. Subsequently, there can be a rapid decline with predictable consequences: falling, bone, muscle, and brain injury, immobility, difficulty working, social isolation, and even weight gain. Should a significant deterioration in balance be detected, simple interventions can be initiated that range from checking for vertigo, abnormal blood pressure, loss of muscle, and the beginning stages of dementia, to seeing if the subject's footwear gives enough support. It seems like such a simple idea: When someone comes in for his or her annual physical examination, carry out the 10-second balance test. Yet are the results relevant? Do they have any bearing on the present and future health of the patient? This was the question the authors of the study set out to answer.

This above-cited trial in the British Journal of Sports Medicine was undertaken in Brazil and assessed various parameters of health status among 1702 individuals, 68% of whom were male. The age of the survey population ranged from 51 to 75 and the study was carried out between 2008 and 2020.

The concept was simple: The researchers wanted to find out whether a balance test might be a reliable predictor of a person’s risk of death from any cause during the decade following the test.

The volunteers underwent a physical examination before the test, including measuring their gait. Those whose gait, i.e., ability to walk at a normal pace, was abnormal were eliminated from the study, as they may have had underlying health conditions such as a neurological disorder that already was impairing their balance.

The test was simple: The volunteers were told to put the front of the free foot on the lower back portion of the foot on the ground. They had to keep their arms by their sides, not windmill them around for balance. And they were told to keep their gaze fixed straight ahead. They had to hold this posture for 10 seconds—which doesn’t seem long until you try it.

The results affirmed what the researchers had predicted: Age had a significant effect on the ability to hold the one-leg position. The youngest group, ages 51 to 55, had the fewest members who failed the test (5%). The numbers rose with age: 8% of the 56- to 60-year-olds, just under 18% of 61- to 65-year-olds, and just under 37% of 66- to 70-year-olds failed the test—as did more than half of those aged 71 to 75.

Obviously, there are many health, age, and lifestyle factors that might have affected the successful passing of the test, and perhaps the longevity of the participants. This was accounted for in the study; for example, when the study began, the authors could not have anticipated deaths from COVID-19 (7%). However even after taking this into account, the authors found that an inability to stand unsupported on one leg for 10 seconds increased the risk of death from any cause by 84%.

This does not mean you should leave your place in line at the airport and rush to find someone to write your will, should you fail the test. But it is worth trying the test at home or some other quiet place where you can concentrate on your balance. And if you find yourself unable to stand unsupported, you should mention this to your health provider at your next visit. Indeed, as the authors suggest, this test should be incorporated into a standard physical examination as a starting point for investigating underlying metabolic, neurological, and orthopedic disorders.

The inability to stand on one leg is not the cause of decreased longevity, but a symptom of medical conditions that may impact this function. This is especially true when found among a younger population. If 99-year-olds can’t balance on one foot, their longevity is not going to be much affected by intense yoga practice or looking into the underlying causes of lack of balance. But if a 56-year-old fails the test, then it is important to see whether the failure is related to a possible neurological or orthopedic disorder, weight gain, inactivity, inner ear issues, or maybe too little sleep and exhaustion. This simple test may lead to interventions that do prolong life.