The simple act of standing on one leg for a few seconds could reveal more about how well you’re aging than other traditional measures, according to new research from Mayo Clinic.
A study published in October in the journal PLOS ONE found that the ability to balance on one leg — particularly the non-dominant leg — showed the steepest decline with age compared to changes in strength or walking patterns. Researchers discovered this was “a more telltale measure of aging than changes in strength or gait,” suggesting that balance tests could become an important tool for healthcare providers assessing age-related decline.
“Balance is an important measure because, in addition to muscle strength, it requires input from vision, the vestibular system and the somatosensory systems,” said Dr. Kenton Kaufman, the study’s senior author and director of the Motion Analysis Laboratory at Mayo Clinic. “If you have poor balance, you’re at risk of falling, whether or not you’re moving.”
The research involved 40 healthy, independent adults over age 50, evenly split between those under and over 65. Participants underwent several assessments including walking tests, balance measurements on force plates, grip strength and knee strength evaluations. For the balance portion, they stood on force plates in various positions: on both feet with eyes open, on both feet with eyes closed, and on each leg individually with eyes open.
Balance deterioration has significant health implications. Falls represent the leading cause of injuries among adults 65 and older, with most resulting from a loss of balance. According to the Centers for Disease Control and Prevention, millions of older adults fall annually, with about 37 percent of these falls causing injuries and approximately 3 million resulting in emergency room visits. The economic impact is substantial — around $50 billion is spent each year in the United States on medical costs related to non-fatal falls alone.
While the research highlights a concerning trend in age-related balance decline, it also offers a straightforward way to assess fall risk. “If you can’t stand on your leg for five seconds, you’re at risk of falls,” Dr. Kaufman explained. This simple threshold provides an accessible metric for both medical professionals and individuals to gauge their risk level.
Research from other institutions supports the Mayo Clinic findings. A study led by researchers at Duke Health found that adults in their 30s and 40s could balance on one leg for nearly a minute, while those in their 50s managed about 45 seconds, and participants in their 70s averaged just 26 seconds. This progressive decline tracks with normal aging processes affecting multiple body systems.
The National Institute on Aging suggests that any healthy adult should aim to balance on one leg for at least 10 seconds with eyes open. Difficulty meeting this basic threshold might warrant a conversation with a healthcare provider. The Mayo Clinic study found that participants older than 65 could stand on their non-dominant leg for an average of 11 seconds, while the overall average across all participants was 17 seconds.
The balance test’s reliability extends beyond age assessment. In a separate 2022 study involving 1,702 adults conducted by researchers at Clinimex, an exercise medicine clinic in Rio de Janeiro, the inability to stand on one leg for 10 seconds was associated with a higher risk of death from any cause within seven years. According to Dr. Claudio Gil S. Araújo, the study’s director, people typically begin to lose their balance around age 60, while flexibility serves as a better marker of aging for younger individuals.
Balance requires a complex interplay of multiple body systems. “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 professor of otolaryngology at Michigan Medicine. “And all three of those have to work together in order to get you around in your environment.”
Age affects these systems in different ways. Vision often deteriorates over time, making it harder to use visual cues for balance. The vestibular system in the inner ear, which helps determine orientation in space, can degrade due to factors like exposure to loud noises—similar to how hearing loss develops. Muscle strength and nerve sensitivity also typically decline with age, further compromising balance ability.
The Mayo Clinic research revealed interesting patterns in how our bodies maintain balance as we age. While all participants could stand normally on two legs for the required 30-second duration, older adults showed more body sway, suggesting they needed to make more frequent adjustments to maintain stability. This increased sway was even more pronounced when participants closed their eyes, highlighting vision’s crucial role in maintaining balance for aging individuals.
The good news is that balance can be trained at any age. Dr. Kaufman recommends a simple daily practice: stand on one leg while brushing your teeth, switching legs halfway through. Tai chi has also been shown to significantly improve balance in older adults.
“If you don’t use it, you lose it. If you use it, you maintain it,” Dr. Kaufman noted. “It’s easy to do. It doesn’t require special equipment, and you can do it every day.”
This research could change how medical professionals approach aging assessment both in clinical settings and at home. The simplicity of the single-leg balance test, combined with its effectiveness across genders, makes it a powerful tool for understanding and monitoring the aging process. Rather than focusing solely on strength or mobility, incorporating balance training into daily routines may prove crucial for maintaining independence and preventing falls as we age.
The study’s significance extends beyond individual health concerns to broader public health implications. With an aging global population, developing effective, accessible methods to assess and improve physical function becomes increasingly important. The one-leg balance test offers a rare combination of simplicity and reliability that could make it valuable in various healthcare settings, from primary care offices to community wellness programs.
