and Medicine for Seniors
Senior’s ability to balance on one
leg may detect brain health, stroke risk
One-leg standing test is easy way to
determine early signs of being at risk for a stroke and cognitive
By Tucker Sutherland, editor, SeniorJournal.com
Dec. 19, 2014 – You know how they
warn you on TV when they are about to show something gruesome. We need
to use that same type of warning on this report. It is about a new study
that finds senior citizens - average age of 67 - that have trouble
balancing on one leg for at least 20 seconds may have increased risk of
small blood vessel damage in the brain - stroke - and reduced cognitive
The research included healthy older
people with no clinical symptoms, according to the report in the
American Heart Association’s journal Stroke.
“Our study found that the ability
to balance on one leg is an important test for brain health,” said
Yasuharu Tabara, Ph.D., lead study author and 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.”
The study consisted of 841 women
and 546 men, average age of 67. To measure one-leg standing time,
participants stood with their eyes open and raised one leg. The maximum
time for keeping the leg raised was 60 seconds.
Participants performed this
examination twice and the better of the two times was used in the study
analysis. Cerebral small vessel disease was evaluated using brain
magnetic resonance imaging.
Researchers found that the
inability to balance on one leg for longer than 20 seconds was
associated with cerebral small vessel disease, namely small infarctions
without symptoms such as lacunar infarction (type of
stroke that results from
occlusion of one of the penetrating
arteries that provides blood to the brain's deep structures) and
Infarct is an area of necrosis (death of body
tissue) in a tissue or organ resulting from
obstruction of the local circulation by a thrombus (a clot of blood
formed within a blood vessel and remaining attached to its place of
origin ) or embolus (abnormal particle circulating in the blood vessel).
They noted that:
● 34.5 percent of those with more
than two lacunar infarction events had trouble balancing.
● 16 percent of those with one
lacunar infarction event had trouble balancing.
● 30 percent of those with more
than two microbleed events had trouble balancing.
● 15.3 percent one microbleed
events had trouble balancing.
Overall, those with cerebral
diseases were older, had high blood pressure and had thicker carotid
arteries than those who did not have cerebral small vessel disease.
However, after adjustment for these
variables, people with
more microbleeds and lacunar infarctions in the brain had shorter
one-legged standing times.
Short one-legged standing times
were also independently linked with lower cognitive scores.
Although previous studies have
examined the connection between gait and physical abilities and the risk
of stroke, this is among the first study to closely examine how long a
person can stand on one leg as an indication of their overall brain
“One-leg standing time is a simple
measure of postural instability and might be a consequence of the
presence of brain abnormalities,” said Tabara.
Small vessel disease occurs due to microangiopathy
(disease of very fine blood vessels) in the
brain, making these arteries less flexible, which can interfere with
blood flow. Small vessel disease typically increases with age. Loss of
motor coordination, including balance, as well as cognitive impairment
has been suggested to represent subclinical brain damage.
Tabara and colleagues also found a
strong link between struggling to stand on one leg and increased age,
with marked shorter one-leg standing time in patients age 60 and over.
Although the study did not assess
participants’ histories of falling or physical fitness issues, such as
how fast they could walk or any gait abnormalities, Tabara said 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.
Previous research has shown that patients with
lacunar infarcts suffer from dementia 4-12 times more frequently than
the normal population. Cerebral atrophy and recurrent stroke, as well as
other as-yet unclarified factors, are involved in producing dementia.
Co-authors areYoko Okada, M.D.,
Ph.D.; Maya Ohara, M.D.; Eri Uetani, M.D., Ph.D.; Tomoko Kido, M.D.,
Ph.D.; Namiko Ochi, M.D., Ph.D.; Tokihisa Nagai, M.D., Ph.D.; Michiya
Igase, M.D., Ph.D.; Tetsuro Miki, M.D., Ph.D.; Fumihiko Matsuda, Ph.D.;
and Katsuhiko Kohara, M.D., Ph.D. Author disclosures and funding are on
balance exercise from American Heart Association.