Inability to balance on one leg for longer than 20 seconds was found to be associated with reduced cognitive function and an increased risk for small blood vessel damage in the brain in otherwise healthy people, according to new research published in the journal Stroke.

“Our study found that the ability to balance on one leg is an important test for brain health,” said lead study author Yasuharu Tabara, Ph.D., associate professor at the Center for Genomic Medicine at Kyoto University Graduate School of Medicine in Kyoto, Japan.

“Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline.”

For the study, 841 women and 546 men (average age of 67) were timed to see how long they could stand on one leg with their eyes open. The maximum time for keeping the leg raised was 60 seconds.

Participants got two chances and the better of their two scores was used in the analysis. Magnetic resonance imaging was used to detect small vessel disease.

Researchers found that struggling to balance on one leg for more than 20 seconds was linked to cerebral small vessel disease, such as lacunar infarctions (a piece of tissue that is dying or dead because of a lack of blood supply) and microbleeds (tiny round hemorrhages). The researchers noted that:

five percent of those with more than two lacunar infarction lesions had trouble balancing;.

16 percent of those with one lacunar infarction lesion had trouble balancing;

30 percent of those with more than two microbleed lesions had trouble balancing;

three percent with one microbleed lesion had trouble balancing.

After adjusting for a variety of factors, people with more microbleeds and lacunar infarctions in the brain had shorter one-legged standing times. Also, people who had shorter one-legged standing times tended to have lower cognitive scores.

Although prior research has examined the connection between gait and physical abilities and the risk of stroke, this is one of the first studies to closely investigate how long a person can stand on one leg as a reflection of overall brain health.

“One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities,” said Tabara.

The researchers also found a strong link between struggling to stand on one leg and increased age, with significant shorter one-leg standing time in patients aged 60 and over. Small vessel disease typically increases with age.

Tabara noted that the one-leg standing test is an easy way to determine if there are early signs of being at risk for a stroke and cognitive impairment and whether these patients need additional evaluation.

Source: American Heart Association

One-Leg Balancing Test May Indicate Brain Health, Stroke Risk