By Rachel Nania, AARP October 2024
Unsteadiness as you get older can put you at greater risk for falls. A quick test that can tell you how well you are aging requires just one thing — or really, just one leg. Researchers from Mayo Clinic have found how long a person can stand on one leg is a better measure of aging than changes in strength or gait (a person’s walking pattern), which are two other characteristics often used to assess healthy aging.
A group of 40 healthy adults over the age of 50 completed walking, balance, grip strength and knee strength tests for the study, published Oct. 23 in the journal PLOS ONE. Half of the study participants were under the age of 65, the others were 65 and older. For the balance tests, participants stood on both legs with their eyes open for 30 seconds, then on both legs with their eyes closed for 30 seconds. With eyes open, they also stood on their dominant leg only for 30 seconds, then switched to their nondominant leg only for another 30 seconds.
The researchers found that the one-legged balance test — especially on the nondominant leg — showed the highest rate of decline with age.
“If you look at all these factors that decrease with age, the ability to balance on one leg was affected the most, or declined the most, with age,” Kenton Kaufman, senior study author and director of the Motion Analysis Laboratory at Mayo Clinic, told AARP. This has serious implications, he says. Chief among them: falls, which are the leading cause of injury for older Americans.
Millions of adults 65 and older fall each year, according to the Centers for Disease Control and Prevention (CDC), and about 37 percent of these falls result in injuries. Roughly 3 million older adults wind up in the emergency room annually due to falls, and around 1 million are hospitalized. What’s more, about $50 billion is spent each year in the U.S. on medical costs related to non-fatal falls, the CDC says.
"If you have poor balance, you're at risk of falling, whether or not you're moving. Falls are a severe health risk with serious consequences,” Kaufman said in a news release.
Why balance can worsen with age
Research suggests that a person’s balance can begin to decline around midlife. In one study led by researchers at Duke Health, adults in their 30s and 40s could balance on one leg for close to one minute. Adults in their 50s were able to stand on one leg for about 45 seconds, and those in their 70s for 26 seconds.
The reason is multifaceted, health experts say. Humans rely on a combination of vision, inner ear balance and a network of muscles and nerves throughout the body to maintain stability while standing and moving, explains Devin McCaslin, chief of audiology and a professor of otolaryngology – head and neck surgery at Michigan Medicine. “And all three of those have to work together in order to get you around in your environment,” he says.
Vision and muscle strength can worsen with age. So can inner ear balance (the vestibular system), which “can lead to people being a little more unsteady,” says McCaslin, who was not involved in the Mayo Clinic study.
Balance can also be affected by conditions that are more common with age, such as arthritis, heart disease and blood vessel disorders, according to the National Institute on Aging (NIA). And certain medications — including some antihistamines, antidepressants, blood pressure pills and diabetes drugs — can interfere with a person’s balance.
A recent CDC study found that roughly 90 percent of U.S. adults ages 65 and older take a prescription medication; more than 40 percent take five or more, according to a report from the Lown Institute.
Improving your balance
The study’s authors note this quick, simple and free test — balancing on one leg with your eyes open — is something individuals can do to assess their own balance. “If you can balance on your leg for 30 seconds and you're over 65, you're doing very well,” Kaufman says. “The number that causes concern is if you can’t balance for 5 seconds.”
McCaslin says the no-frills test could also help doctors screen patients and identify those with a balance issue so they can work to treat or improve it, depending on the cause.
Physical therapy exercises that involve moving the head and body in certain ways can help improve vestibular (inner ear) issues. And balance problems due to high blood pressure can be managed by eating less salt, maintaining a healthy weight and exercising, the NIA says. If medications are to blame, your doctor may make some adjustments.
Staying physically active — McCaslin recommends walking — and keeping up with strength training as you age can help you maintain and improve balance.
“A little practice won't hurt either,” says Kaufman, who stands on one leg at least once a week. In a news release, he added, “It’s easy to do. It doesn't require special equipment, and you can do it every day.”
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