Got balance? For older adults, how long you can stand on one leg may be a key indicator of well-being and how well you are aging. The changes in balance that happen as we grow older provide a more revealing measure of aging than changes in strength or gait, a new Mayo Clinic study found.
Good balance, muscle strength, and an efficient gait contribute to people’s independence and well-being as they grow older, says senior author Kenton Kaufman, PhD, director of the motion analysis laboratory at Mayo Clinic in Rochester, Minnesota.
Gait is how a person walks, and changes in gait can lead to falls, pain, and other health issues.
Understanding how these areas decline over time could help healthcare providers identify people who may benefit from interventions to help them maintain mobility and independence.
Why Balance Is a Good Indicator of How You Well You’re Aging
The cross-sectional study (meaning the participants were measured at a single point in time) included a total of 40 people — 20 men and 20 women. Half of the participants were 56 years old on average, and the other half were an average age of 74.
The following tests were used to assess any age-related declines or differences between men and women:
- Grip Strength A handheld device was used to measure upper body strength.
- Knee Strength Knee extension exercises assessed lower body strength.
- Gait Participants walked at their own pace on a designated path while their movements were captured using a motion analysis system.
- Balance Participants stood on plates that measured balance in four different scenarios: on both feet with eyes open, with eyes closed, and on the dominant and nondominant leg with eyes open.
In the one-legged tests, participants could hold the leg they weren’t standing on where they wanted. The tests were 30 seconds each.
In considering the results, researchers accounted for factors like the size of the person (larger people tend to be stronger) and height (longer legs usually mean faster walking).
Of all the measures, they found that standing on one leg — specifically the nondominant leg — showed the highest rate of decline with age.
“Balance is an important measure because, in addition to muscle strength, it requires all your body systems to work together. Good balance allows you to carry out your activities of daily living without fear of falling,” says Dr. Kaufman.
Falls Cause a Million Hospitalizations Each Year
If you have poor balance, you’re at risk of falling, whether or not you’re moving, Kaufman says.
“Falls are a severe health risk that can have life-changing consequences. I think nearly everybody has a story of someone they know, a family member or a close friend, who has fallen, or they have an older parent who has fallen recently,” says Kaufman.
Each year, there are about three million emergency department visits due to older people falling, and about one million fall-related hospitalizations.
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Other key findings included:
- Grip and knee strength showed significant declines by decade, but not as much as balance. Grip strength decreased at a faster rate than knee strength, making it better at predicting aging than other strength measures.
- For the gait test, participants walked back and forth on a level 8-meter walkway at their own pace and speed. Gait parameters didn’t change with age, which made sense, since participants were walking at their normal pace, says Kaufman.
- There were no age-related declines in the strength tests that were specific to sex, which suggests that people’s grip and knee strength declined at a similar rate.
Loss of Balance Could Be the ‘Canary in the Coalmine’
For this study, the researchers looked at three domains related to aging that have all been studied for a long time, and then put all those pieces together to see what’s most important, says Carolynn Patten, PhD, a professor of physical medicine and rehabilitation at UC Davis Health in California. Dr. Patten specializes in assessment and treatment of motor dysfunction associated with aging and was not involved in this research.
These findings could be useful in part because doctors are often pressed for time and there can be a lot to cover in an office visit, she says.
“This could help providers focus on a measure such as balance to see how a person is aging. It could be the ‘canary in the coalmine’ that’s one of the first things to go, and we need to pay more attention to that,” says Patten.
Because the group studied here was small, only 40 people, the findings should be interpreted with caution, she adds.
How to Improve Your Balance
The good news is that working on your balance is simple and you can do it just about anywhere, says Kaufman.
“You can do this at home while you’re washing dishes or brushing your teeth. Just time yourself on how long you can spend on one leg,” he says.
Make sure you have a chair or a wall nearby to steady or catch yourself, says Kaufman.
If you can stand on one leg for 30 seconds, you are doing well, he says.
“In our group of people over age 65, they averaged 11 seconds. The number that causes concern would be below five seconds. That says you’re at risk of falling,” says Kaufman.
By standing on one leg, you’re training yourself to coordinate your muscle and vestibular responses to maintain correct balance.
The vestibular system includes structures inside your inner ear (called otolith organs) and semicircular canals that detect head movements. Your brain uses this information to help you balance.
“If you practice balance, you’re more likely to maintain it. It doesn’t require special equipment, and you can do it every day,” he says.
