Medical Feature: Longevity?

You need a leg to stand on! Find out why...

FTR Standing on One Leg Health TestFlamingos everywhere have it right! A new study shows that the ability to stand on one leg for at least 10 seconds is strongly linked to the risk of death over the next seven years. According to the findings, people in middle age and older who couldn’t perform the 10-second-standing test were nearly four times as likely to die of any cause ― heart attacks, strokes, cancer, and more ― in the coming years than those who could, well, stand the test of time.

Claudio Gil Araújo, MD, PhD, research director of the Exercise Medicine Clinic-Clinimex in Rio de Janeiro, Brazil, who led the study, called the results, “awesome!”

“As a physician who has worked with cardiac patients for over four decades, I was very impressed in finding out that, for those between 51 and 75 years of age, it is riskier for survival to not complete the 10-second one-leg standing test than to have been diagnosed as having coronary artery disease or in being hypertensive” or having abnormal cholesterol, according to Araújo. Unlike aerobic fitness, muscle strength and flexibility, balance tends to be reasonably well preserved until the sixth decade of life, when it starts to wane relatively rapidly, noted the researchers in the study published in the British Journal of Sports Medicine.

The 10-second-balance test “provides rapid and objective feedback for the patient and health professionals regarding static balance” and that the test “adds useful information regarding mortality risk in middle-aged and older men and women.” Researchers have known for at least a half century that balance and mortality are connected. One reason is falls – according to the World Health Organisation, worldwide, more than 37 million falls each year require medical attention with nearly 700,000 people each year dying as a result of a fall.

Araújo and his colleagues have been working on ways to improve balance and strength as people age. In addition to the one-legged standing test, previously they connected the ability to rise from a sitting position on the floor as being a strong predictor of longevity. For the new study, the researchers assessed 1,702 people aged 51–75 years who had been participating in an ongoing exercise study that began there in 1994.

Starting in 2008, the team introduced the standing test, which involves balancing on one leg and placing the other foot at the back weight-bearing limb for support. People get three tries to maintain that posture for at least 10 seconds.

Not surprisingly, the ability to perform the test dropped with age. Although 20% of people in the study overall were unable to stand on one leg for 10 seconds, that figure rose to about 70% for those aged 76–80 years, and nearly 90% for those aged 81–85, according to the researchers. Of the two dozen 85-year olds in the study, only two were able to complete the standing test. At roughly age 70, half of people could not complete the 10-second test. Over an average of seven years of follow-up, 17.5% of people who could not manage the 10-second stand had died, compared with 4.5% of those who could last that long, the study found.

After accounting for age and many other risk factors, such as diabetes, body mass index, and a history of heart disease, people who were unable to complete the standing test were 84% more likely to die from any cause over the study period than their peers with better one-legged static balance.

Although low aerobic fitness is a marker of poor health, much less attention has been paid to non aerobic fitness ― things like balance, flexibility, and muscle strength and power. “We are accumulating evidence that these three components of non-aerobic, physical fitness are potentially relevant for good health and even more relevant for survival in older subjects,” Araújo said. Poor non-aerobic fitness, which is normally but not always associated with a sedentary lifestyle, “is the background of most cases of frailty, and being frail is strongly associated with a poor quality of life, less physical activity and exercise, and so on. It’s a bad circle.”

Araújo’s group has been using the standing test in their clinic for more than a dozen years and have seen gains in their patients, he said.”Patients are often unaware that they are unable to sustain 10 seconds standing one legged. After this simple evaluation, they are much more prone to engage in balance training,” he said.

I like to encourage my patients to fulfil their childhood fantasy of joining the circus. If you stand on one leg long enough, you might just be ready for the high wire act by your 100th birthday.

(News: Health Feature – Dr Paula Anthony)

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