One-legged Test for Longevity

Over 50? This simple test may predict your chance of a longer life

How long can you hold this position?. VStock LLC/Tanya Constantine/Getty Images

Throughout history mythological storks have heralded a new birth, but researchers in the United Kingdom have found that how long you can stand like this tall bird could signal your risk of an early death.

It's called the standing balance test, and a 2014 paper published in the British Medical Journal revealed that subjects who were able to stand on one leg for a given period - with their eyes closed - had a lower chance of dying within the 13 years of follow-up study.

Why a balance test?  The scientists, led by Rachel Cooper of the MRC Unit of Lifelong Health and Ageing at University College London, write that better performance on physical capability tests such as hand grip strength and walking pace has been linked with lower mortality from any cause.

There are some logical explanations for this association between physical capacity and better longevity: declining physical performance could indicate undiagnosed disease, declining musculoskeletal strength and greater fall risk, while better capability could represent greater resilience against age-related illnesses like cardiovascular disease, diabetes and dementia.

Surprisingly however, exactly why physical performance is linked so strongly with mortality has not been thoroughly explained in the existing research.

 That's according to a major meta-analysis led by Cooper in 2010, also published in the British Medical Journal.  Few studies have been conducted on subjects younger than the age of 60 to determine how physical capability may decline over time, and most research had only followup times of less than 10 years.

 Still, how well you perform on a physical test is a measure of your level of overall health and conditioning, and therefore your chance of living a longer life.

The study subjects:  All of the subjects were part of a birth cohort study begun in 1946 in England, Scotland and Wales.  For this investigation, 2,766 participants were contacted in the late 1990s at the age of 53, and followed up until age 66 in 2012, for a total of 13 years.  

The standing balance test itself:  Along with other physical capability testing of grip strength and chair rise time, the adults were asked to stand for as long as possible on one leg (to a maximum of 30 seconds), with their eyes closed.  The test was repeated three times with a nurse standing by with a stopwatch. 

The subjects were grouped by length of standing time achieved.  Among the men able to complete the test, an average time of 5 seconds in the poorest-performing group was recorded, with those doing best logging an average time of 19 seconds.

The top-performing women stood for an average of 10 seconds with their eyes closed, but only an average of 3 seconds in the lowest group.

These times might seem short - but try the test yourself.  It's more difficult than it sounds!

What the researchers found:  After 13 years, deaths among participants were recorded through the UK National Health Service central registry.  Subjects in the lowest-performing groups had a 2.5 times greater risk of death when compared with the highest-performing groups, even after accounting for gender, body size (height and body mass index or BMI), lifestyle risk factors like smoking and physical activity, and whether the subject had an existing illness such as cardiovascular disease or diabetes.

Among those men and women unable to complete the standing test at all, a much greater risk of death - 9.6 times - was revealed.

Cooper's team writes that subjects with poor performance in the standing balance test (and the other tasks included in her study) are an important group to target for intervention.  While the types of programs most effective at improving balance, strength and flexibility in mid-life have not been firmly established, physical activity in general has been shown to improve longevity.  Further, a mid to late-life fall can pose a serious threat to an older adult's mobility, independence and life span;  a fall is the top cause of injury and deaths due to injury in people over the age of 65.

How to improve your balance:  While we wait for the research community to establish which types of exercise do the most good for our overall balance, programs like yoga and Tai Chi have been shown to promote postural stability - along with stress reduction - in older adults. Since these practices bring tangible benefits, and few negative side effects, there's no reason not to give them a try.


Cooper R, Kuh D, Hardy R; Mortality Review Group. Objectively measured physical capability levels and mortality: systematic review and meta-analysis. BMJ 2010;341:c4467.

Cooper Rachel, Strand Bjørn Heine, Hardy Rebecca, Patel Kushang V, Kuh Diana. "Physical Capability in Mid-life and Survival over 13 years of Follow-up: British Birth Cohort Study." BMJ 2014; 348 :g2219

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