This Simple Fitness Test Predicts Fall Risk In Older Adults

Getting older can be tough for a multitude of reasons, not the least of which is the increased risk of falling and hurting yourself. According to the Centers for Disease Control and Prevention, more than 14 million older adults fall every year, and falls are the top cause of fatal and nonfatal injuries in this age group.

It’s hard to know if you’re at risk of suffering from a fall. However, a recent study led by researchers at the Mayo Clinic found that one fitness test can help determine your fall risk: the ability to stand on one leg.

The study, which was published in the Public Library of Science One journal, looked at 40 healthy people over the age of 50 with no neuromuscular disorders. Half of the participants were under 65, while the others were 65-plus.

Researchers measured knee strength, grip strength, gait while walking on a flat path, and 30 seconds of balancing on one leg. Of all measures, balancing decreased most with age; the ability to stand on one’s nondominant leg declined 2.2 seconds per decade, while the ability to stand on one’s dominant leg declined at 1.7 seconds per decade.

Researchers looked at various balance studies and discovered that testing the balance on the nondominant leg was the best way to measure age-related neuromuscular decline, according to Dr. Jeevan Abraham, a sports medicine physician at Northwestern Medicine in Chicago who was not affiliated with the study.

This is important because the better the balance, the lower the risk of falling.

“Every time you take a step, you’re standing on one leg while you’re taking that step,” said Dr. Gregory W. Stewart, the co-founder and co-director of the Center for Sport at Tulane University in New Orleans, who was also not affiliated with the study. If your balance has decreased, you could fall, potentially leading to an injury.

“As you age, a lot of people lose bone mass … so a fall could cause a break,” Stewart said, noting that folks could hit their head and get a concussion or brain bleed.

Balance can also be indicative of how your brain is working in some areas.

“As you start getting into issues of balance, you’re really taking in more areas of the brain — certainly some of it is strength, but you’ve got vision, you’ve got the inner ear vestibular system, you’ve got all the coordination that goes along in the nervous system … it’s more than just strength,” Stewart said. “It makes a lot of sense as being one of the first things to go because it integrates so many areas of the nervous system.”

This study does have limitations, though: with only 40 people, it’s a small sample size. Additionally, only healthy people were included, which means these findings may not apply to people with health conditions.

So, just how long should you be able to balance? The answers are mixed.

In the study, researchers had participants balance for 30 seconds at a time. In a press release, study author Kenton Kaufman said, “If you can stand on one leg for 30 seconds, you are doing well.”

“I’m sure there’ll be plenty of people who are probably not going to make it to 30 seconds, but I think that’s a good way to see what’s the duration of balance within that time period,” Abraham said.

You shouldn’t get discouraged if you can’t balance for 30 seconds, Stewart said, adding that most people likely won’t hit that number, but 15 to 20 seconds is a good goal for balancing on one leg.

“My first suggestion is just to avoid long periods of time sitting,” Abraham said.

“Personally, just from my practice, I tell my patients I wouldn’t suggest sitting longer than 30 minutes at a time, just because the more you get up, the less likely that your muscles are going to become deconditioned,” he added.

So instead of sitting at your computer for hours on end, get up from time to time, even if it’s just to get a glass of water or walk over to pet your dog.

“And then try to instill daily habits such as using stairs when possible [and a] daily walking routine because these little things really do add up,” Abraham said. “Neglecting those things is what I think leads to certain people losing their abilities of balance and strength.”

Additionally, every decade starting at 30, folks lose 8% of their muscle mass, Abraham said. This makes it crucial to build your strength as you age, too, something he explained can be done through resistance training.

You can try doing chair squats, which require no additional equipment (other than a chair), or challenge yourself to the weight machines at the gym. Bodyweight exercises, such as push-ups, planks and jumping jacks, are another great place to start.

“Engaging in resistance training is very important for everybody,” Abraham said.

Yoga and tai chi are also good ways to focus on your balance, Stewart said, recommending that people start as early as possible and not only when you start noticing balance changes.

However, before diving into a new fitness routine, you should talk with your doctor and even a physical therapist to learn ways to improve your balance and overall fitness safely.

It’s easy to explain away falls or make up excuses as to why they happen. But Stewart said that isn’t something you should do or accept from an elderly relative.

“We can all have an ‘oops’ and have one fall, but if you have more than one … you probably should go ahead and see someone and make sure that you’re not at risk for something else,” Stewart said.

Falls can be the result of balance issues as well as strength, inner ear, and visual problems, he noted. Arthritis can even cause balance problems, Abraham added.

No matter the cause, it’s important to see your primary care doctor or a physical therapist who can help determine exactly what’s going on.

While cardio exercise and strength training may often take the spotlight, balance is also worth your attention when it comes to overall health and healthy aging.

“I think we take [balance] for granted as we’re younger,” Abraham said, adding that maintaining balance is essential if you want to have a certain quality of life as you age.

If you can’t easily balance as you walk or you constantly injure yourself because of falls, you won’t be able to achieve many of the retirement-age goals people have, like traveling, playing on the floor with your grandkids or getting around to see friends and family.

“Balance is a sign of aging and something that you can potentially do something about,” Stewart said. “There are actually things that you can do from a training standpoint [and] the earlier you get on it, the less issues that you’re going to have.”