A new study found that middle-aged and older adults who could successfully stand on one leg for 10 seconds had a significantly lower risk of dying over the next 7 years compared to those who failed the simple balance test. This quick assessment may capture overall body strength and control that predicts longevity.
A new study published in the British Journal of Sports Medicine assessed whether the simple ability to stand on one leg for 10 seconds predicts risk of early death (Araujo et al., 2023).1 Called the flamingo test because it resembles a pink bird balancing perfectly still on one spindly leg, this quick assessment of static balance captured overall muscle strength and joint flexibility that foretold longevity over a 7-year period. Out of 1,702 Brazilian adults aged 51-75 years, nearly 80% succeeded while 20% failed, waving arms or hopping to regain control. Just under 5% of flamingo test passers died during follow-up versus over 17% of failers. The one-legged stance remained strongly linked to survival even after considering age, sex, weight, diseases like diabetes, and medications. Failing at midlife more than doubled later mortality hazard.
Balance steadily deteriorates starting around age 50, raising risks of falls and fractures linked to earlier death and poorer quality of life.2 Yet many adults do not receive standard balance assessments during routine exams.3 This study confirms the value of incorporating a simple 10-second one-legged flamingo stance into checkups for middle-aged and older patients. Beyond signaling current fall risk, it may provide a snapshot of overall muscle and neurological health that predicts longevity as effectively as blood pressure and cholesterol scores. People who cannot balance for 10 seconds may require interventions like strength training, tai chi, medication adjustment, or home safety modifications to prevent future falls and prolong survival.
For the study, a trained instructor demonstrated proper one-legged standing technique with eyes open and bare foot lifted behind the body without touching the standing leg.4 Participants then attempted to balance steadily for 10 seconds with each reminder to resume the initial stance if foot position changed or arms waved. Most subjects chose their dominant leg and three attempts were allowed. Just over 80% passed on the first try and nearly 97% eventually met the 10-second benchmark before completing surveys on lifestyle, medical history and medications.5 Researchers tracked electronic medical records over the next 7 years to record deaths from any cause.
Failing the flamingo test more than doubled the risk of dying during follow-up after factoring in effects of age, sex, weight, diseases like cancer and heart conditions, and use of drugs influencing balance like sedatives.6 Adding the flamingo variable significantly improved a statistical model’s ability to predict individual risk of death based on age and health alone. Study authors speculate that inability to balance for 10 seconds signals bodily decline - like muscle loss, joint degeneration, and neurological problems - that foretells earlier mortality.7 They call for incorporating the simple flamingo stance into routine patient exams to screen for elevated risks prompting preventive measures.
The study relied on balance tests at one point in time, so cannot determine if intervening to improve stability might modify expected lifespans.8 Other limitations include the mostly male sample not generalizable to all populations and survival tracking based solely on electronic records.9 Still this well-designed study controlled key variables known to influence mortality like obesity and diabetes, so strongly suggests balance ability provides independent insight into expected longevity.
This study does, however, indicate how important intentional movement and exercise is for overall health and longevity. Our research database on exercise, based on nearly 1,000 studies, shows that exercise can prevent or improve over 240 different health conditions. This indicates, as does the study featured in this report, that moving your body, regularly, has profound benefits that can not be over-emphasized. Move it or lose it is saying that is becoming truer every day, as the science accumulates proving it continues to expand.
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References
1. Araujo, C. G., de Souza e Silva, C. G., Laukkanen, J. A., Singh, M. F., Kunutsor, S. K., Myers, J., Franca, J. F., & Castro, C. L. (2023). Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals. British Journal of Sports Medicine, 57(3), 181-186. https://doi.org/10.1136/bjsports-2021-105063
2. Pijnappels, M., Delbaere, K., Sturnieks, D. L., & Lord, S. R. (2010). The association between choice stepping reaction time and falls in older adults--a path analysis model. Age and ageing, 39(1), 99-104. https://doi.org/10.1093/ageing/afp224
3. Tinetti, M. E., Speechley, M., & Ginter, S. F. (1988). Risk factors for falls among elderly persons living in the community. New England Journal of Medicine, 319(26), 1701-1707. https://doi.org/10.1056/nejm198812293192604
4. Araujo, C. G., de Souza e Silva, C. G., Laukkanen, J. A., Singh, M. F., Kunutsor, S. K., Myers, J., Franca, J. F., & Castro, C. L. (2023).
5. Ibid.
6. Ibid.
7. Ibid.
8. Ibid.
9. Ibid.
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