Not Being Able to Stand in This Position Increases Mortality Risk by 84%

Recent studies have discovered that middle-aged and elderly people who cannot stand on one leg for more than 10 seconds have almost double the risk of death in the next decade. Why is the ability to stand on one leg” related to mortality? There are two key reasons, and improving these issues can help reduce the risk of death.

The British Journal of Sports Medicine published a new study assessing the association between the ability to complete a 10-second one-legged stance and all-cause mortality in middle-aged and older adults.

Between 2008 and 2020, a total of 1,702 (68 percent male) volunteers aged 51 to 75 years participated in the study. A total of 20.4 percent were unable to complete the 10-second one-legged stance, and the older the volunteers, the higher the probability of failing the test.

During a follow-up (median of 7 years), 7.2 percent of the volunteers passed away, with cancer and cardiovascular diseases as the main causes of death, as well as respiratory diseases and COVID-19 complications. Among them, 4.6 percent were able to stand on one leg for more than 10 seconds, and 17.5 percent were unable to stand for more than 10 seconds.

Compared with those who passed the test, those who could not stand on one leg for more than 10 seconds had significant differences in age, waist-to-height ratio, and BMI. Moreover, their health status was also relatively poor, mostly suffering from hypertension, hyperlipidemia, diabetes, cardiovascular diseases, and obesity.

After taking age, gender, and underlying conditions into account, the study pointed out that people who were unable to stand on one leg for 10 seconds had an 84 percent increased risk of death from any cause in the next decade, which is equivalent to almost double the risk of people who passed the test.

The length of time a person can stand on one leg is related to his or her sense of balance and muscle strength.

Sense of Balance

Dr. Scott Wang, director of Star Rehabilitation Clinic in Neihu District, Taiwan, pointed out that sense of balance is very important, and elderly people with poor balance are prone to falls.  He said, “Some of my patients in their 60s and 70s will tell me things like they fell again last week, or fell three times in the last month.”

Falls are a major threat to seniors.

This is because the harm caused by falls can be minor or major, ranging from scratches and bruises to serious fractures and even loss of life.

“When I was working in a hospital, a patient fell out of bed, causing a brain hemorrhage, and he passed away,” Dr. Wang said.

Sense of balance deteriorates as one ages, and the maintenance of sense of balance involves vision, the semicircular canals (the organs responsible for the sense of balance) in the ear, and proprioception. Vision deteriorates with age, affecting the elderly’s ability to walk; the semicircular canals are also affected by aging, as well as vertigo; and proprioception does not only deteriorate due to aging, but is also related to diabetes.

Most people can close their eyes and still put the index fingers of both of hands together, which is a function of proprioception. Proprioception allows a person to detect the position of a limb in space without being able to see it.

Diabetic patients with poor blood sugar control can suffer damage to their proprioceptive nerves, resulting in insensitivity of the peripheral limbs and a poor sense of balance. Dr. Wang said that one of his patients doesn’t have feeling in his feet, so when he walks, he feels as if walking on a marshmallow. “This kind of feeling is very scary, and the general population can’t really imagine it,” he said.

In addition, a deteriorated sense of balance may also be a sign of an asymptomatic stroke (silent stroke).

Dr. Chih Hao Lin, neurologist and director of the Brain Stroke Center at Lin Shin Hospital in Taiwan, said that most asymptomatic strokes are small strokes, in which small blood vessels or capillaries under the cerebral cortex become embolized. Since the symptoms are very mild, they may not be detected without special attention or examination. However, these asymptomatic strokes may lead to major strokes.

Patients with asymptomatic strokes may experience a slight loss of balance, unstable gait, weakness in walking, and changes in their field of vision, including not being able to see with one of their eyes. The danger is that the symptoms are so light the patients do not detect them.

Muscle Strength

Muscle strength is also an important factor that affects the sense of balance. “Even if a person has good vision, balance and proprioception, if his muscles are severely atrophied, he is still prone to falls,” Dr. Wang said.

At the same time, muscle strength alone can predict a person’s longevity.

In addition to standing on one leg, a meta-analysis published in the British Medical Journal in 2010 found that people with poor grip strength, a slow walking speed, and slow chair rises also have relatively high future all-cause mortality:

• Those with the weakest grip strength had 1.67 times the mortality rate of those with the strongest grip.
• Those who walked the slowest had 2.87 times the mortality rate of the fastest group.
• The people who took the most time to rise from a chair had 1.96 times the mortality rate of the fastest people.

These abilities are also related to muscle strength. The most effective way to improve muscle strength is weight training, and Dr. Wang emphasized that “weight training can cure various diseases.” Excellent muscle strength brings many health benefits.

As muscle mass increases, it can prevent sarcopenia, increase bone density, reduce the risk of fractures, maintain joint flexibility to reduce arthritis symptoms, lose weight, and increase physical flexibility and balance.

People with a thick waist circumference have a lot of visceral fat accumulation, and their body is in a state of chronic inflammation, with metabolic problems. They are prone to fatty liver, and having high blood pressure, high blood lipid, and high blood sugar levels, and their future risks of cancer and diabetes are also relatively high. Compared to aerobic exercise, weight training has the best effect on reducing and controlling waist circumference.

Harvard T.H. Chan School of Public Health published a comprehensive review last year, showing that 60 to 150 minutes of muscle-strengthening activities per week can reduce the risk of cardiovascular disease by 20 percent to 25 percent, the risk of type 2 diabetes by 30 percent, cancer mortality by 15 percent to 20 percent, and all-cause mortality by about 20 percent to 25 percent.

During the COVID-19 pandemic, a study from Switzerland found that people with greater grip strength had lower hospitalization rates for COVID-19.

Dr. Wang added that weight training is good for blood sugar and blood pressure control. Some people may worry that when doing weight training, people’s faces tend to turn red, so won’t weight training increase blood pressure instead? He explained that the blood pressure will rise during exercise, but it will decrease after exercise. People who do weight training regularly have well-controlled blood pressure when they are not exercising.

Training Can Improve Muscle Strength and Balance

In addition to the sense of balance and muscle strength, whether or not someone can stand on one foot for more than 10 seconds also reflects a person’s exercise habits. People who habitually exercise are more physically fit and can stand on one leg for a longer period of time.

If you want to train your sense of balance and improve your muscle strength, first of all, it is necessary to cultivate exercise habits, and add the following training to your weekly routine:

Deadlifts and Deep Squats

Excellent weight training needs to take into account both upper and lower body muscles, but muscle training of the lower body brings the greatest benefits, because the muscles below the waist account for two-thirds of the total body muscle mass.

Deadlifts and deep squats mainly exercise the lower body. They also work the muscles of the entire body, making them highly efficient exercises for gaining muscle.

Sense of Balance Training

This training method is very simple: on the floor, draw (or paste) a line, and walk heel-to-toe along the line back and forth.

Dr. Wang pointed out that to enhance one’s sense of balance, improving muscle strength is indispensable, and some balance training should also be added to form a complete approach.

Regardless of whether it is weight training or balance training, seniors are advised to have a coach to assist them in doing these exercises to avoid falls and movement errors that can cause sports injuries.