How long can you stand on one foot? The answer may predict your fall risk.

What we know about balance as we age

Our balance comes from several sensory inputs: our vision, specialized nerve receptors in the muscles and joints sensitive to movement, and, also, structures in our inner ear that help us determine our orientation in space.

“As we start to age, what happens is all of these systems start to degrade,” said Devin McCaslin, chief of audiology and otorhinolaryngology at the University of Michigan. “They’re all contributing in one way or another.”

The inner ear’s sense of balance can deteriorate over time because of exposure to loud noises — in the same way someone can develop hearing loss, McCaslin said.

“As people get older, the changes in the inner ear of balance and the brain makes it harder for them to maintain balance,” he said. “It really pops up in challenging environments, like walking in the dark.”

Jay Hertel, the chair of kinesiology at the University of Virginia, said the reason a decline in balance among older adults is a concern is because falls can be dangerous.

“We want to have older individuals maintain and train their balance so that they’re more resistant to suffering falls,” he said.

The limitations of the study

The researchers conducted a cross-sectional study, measuring participants’ data at a single point in time rather than a longitudinal study, which follows participants for years, or decades, to monitor for potential age-related decline.

Kaufman said another limitation of the study is the sample size of 40 participants. He said more participants would make the study more robust.

What other experts say

Lyndon Joseph, an exercise physiologist in the division of geriatrics and clinical gerontology at the National Institute on Aging, said more research is needed to better understand how clinicians could make use of this balancing test.

“To really validate this, it’s probably going to have to be done in a larger population,” Joseph said. “But this is an interesting start.”

Hertel said it’s “a great study” because researchers don’t often assess balance, gait and strength at the same time. But he said he would have been interested in seeing more challenging gait assessments for the participants, such as walking while counting backward from 100 by threes.

Claudio Gil S. Araújo, the director of research and education at Clinimex, an exercise medicine clinic in Rio de Janeiro, said the study reinforces the idea that balancing on one leg is a simple tool clinicians can use to evaluate a person’s balance.

In a 2022 study of 1,702 adults, Araújo and a team of researchers found the inability to stand on one leg for 10 seconds was associated with a higher risk of death from any cause within seven years.

People start to lose their balance at about 60 years old, Araújo said. For people younger than that, flexibility is a better marker of aging.

How to improve your balance

Experts say regular exercise is key to improving balance. Tai chi, specifically, can improve balance in older adults, Kaufman said.

People can incorporate balancing into daily routines, for example, standing on one leg as you’re brushing your teeth, switching legs halfway through, Araújo said. Or when you reach to open a door, hold the doorknob and balance for 10 seconds on one leg.

Kaufman practices standing on one leg every week to maintain his balance.

“Some days, I’m able to go for the full 30 seconds, and some days, I don’t,” he said. “But at least I’m practicing.”

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