Balance Function Serves as a Key Marker for Healthy Aging
Good balance isn't just about staying upright - it's a powerful predictor of overall health and vitality as you age.
STORY AT-A-GLANCE
Balance function serves as a key predictor of healthy aging and longevity, with better balance scores correlating directly to increased life expectancy and reduced health risks
People with poor balance scores face three times higher hospitalization rates and double the risk of developing chronic diseases compared to those with good balance
Balance training creates measurable improvements in brain structure, increasing both gray matter volume and forming new neural connections that enhance overall cognitive function
A simple 10-second one-leg balance test accurately predicts mortality risk in adults over 50, proving more reliable than many complex medical assessments
Practicing balance exercises for just 12 weeks improves both physical stability and brain function, with benefits appearing across all age groups
Having good balance becomes increasingly important as you age. It plays a central role in maintaining functional ability, preventing falls, and supporting overall well-being in older adults.1
Physical stability affects far more than just your ability to stay upright. A comprehensive analysis of balance function published in the Journal of Clinical Medicine demonstrates strong connections between balance capacity and numerous health markers, including cognitive performance, cardiovascular fitness, and overall mortality risk.2
So, assessing your balance can provide valuable insights into your current health status and future outcomes. Advanced assessment tools like the Balance Evaluation Systems Test (BESTest) offer detailed analysis of different balance systems, allowing healthcare providers to identify specific areas needing attention before serious problems develop,3 but even simple balancing tests done at home can give you a clear idea of where you’re at in terms of risk.4
Balance Testing Reveals Strong Links to Overall Health and Function
A groundbreaking study from Portugal's University of Aveiro examined the relationship between balance ability and multiple aspects of healthy aging. Researchers analyzed 118 older adults using comprehensive balance assessment tools, including the BESTest and its shorter versions, the Mini-BESTest and the Brief-BESTest.
Other tests included the Five Times Sit to Stand (5STS), the 10 Meter Walk Test (10MWT), the Brief Physical Activity Assessment Tool (BPAAT) and the World Health Organization’s Quality of Life-Bref (WHOQoL-Bref).5
Testing revealed significant correlations between balance performance and key health indicators. Study participants averaged 76 years old, with 66.9% being female. The research team discovered that individuals with better balance scores demonstrated superior functional ability, faster walking speed, higher physical activity levels, and improved quality of life measurements overall.6
As you might expect, balance testing also proved remarkably accurate at identifying those at risk for falls. People who experienced multiple falls scored significantly lower on all balance tests compared to those who had only fallen once or not at all. This distinction appeared most clearly when using the Mini-BESTest, which takes just 10 to 15 minutes to complete.7
Physical activity levels were strongly connected to balance ability. The researchers noted that while most participants (73.7%) were classified as insufficiently active, those with better balance scores maintained higher activity levels. Every single person in the multiple-falls group ranked as insufficiently active, highlighting the critical relationship between movement and stability.8
Walking speed emerged as another crucial indicator tied to balance function. Study participants with superior balance scores walked significantly faster during standardized tests. This finding matters because walking speed serves as a well-established predictor of overall health and independence in older adults.
Quality of life scores painted an equally compelling picture. Better balance correlated strongly with higher scores across all domains of the World Health Organization Quality of Life assessment, including physical health, psychological well-being, social relationships, and environmental factors.
The research team identified specific cutoff points that healthcare providers can use to identify individuals at risk. For example, taking longer than 13.5 seconds to complete five sit-to-stand movements, or walking slower than 1.2 meters per second, signals increased fall risk and the need for intervention.
Physical Strength and Balance Work Together to Enhance Life Quality
Related research from Portugal's University of Madeira tracked 802 older adults to understand how muscle strength and balance affect quality of life. The research found that leg strength and postural stability act as crucial intermediaries between physical activity and overall well-being.9
Physical activity benefits appeared to work through two main pathways. Better leg strength accounted for 39.6% of activity's positive effects on quality of life, while improved balance contributed another 47%. Together, these factors explained an impressive 98% of the relationship between staying active and feeling better.
This study also revealed important details about how age affects stability. Around 20% to 30% of your muscle mass disappears between young adulthood and age 80, with fast-twitch muscle fibers declining most rapidly. This loss particularly impacts the ability to make quick postural corrections when balance gets disturbed, resulting in falls.
Your central nervous system constantly monitors position information from visual, inner ear, and body sensors. It then rapidly decides which muscle responses will most effectively restore balance when needed. Age-related changes in muscle fibers disrupt this complex system. As noted by the researchers:10
"A possible cause of muscle strength loss in advanced age may be type II skeletal muscle fiber atrophy due to physiological aging. One explanation for the impairment of the vasodilator function of muscle fibers is the progressive and gradual loss of capillaries.
On the other hand, a strategy to increase capillary supply is the regular practice of physical exercises, capable of increasing muscle blood flow. In old age, a possible cause of muscle strength loss may be type II skeletal muscle fiber atrophy, which may be associated with decreased physiological reserve, known as frailty."
The research identified specific strategies older adults use to stay upright. When balance gets challenged, they employ three sequential responses: ankle adjustments, hip movements, and stepping. The brain controls this process by sending signals to hip and ankle muscles to generate compensatory movements.
These findings highlight the importance of specific training approaches that combine traditional strength work with rapid movement patterns, to help activate more muscle fibers. Activities like multitasking physical exercises, dance, and dual-task training prove particularly effective at building both strength and stability.11
Brain Activity During Balance Shows Clear Age-Related Patterns
Groundbreaking research using advanced brain imaging reveals how older and younger brains differ when maintaining balance. Scientists at the University of Freiburg used near-infrared spectroscopy to observe brain activity in 62 adults as they performed various balance tasks.12
The study uncovered stark differences between age groups. Younger adults showed less activity in their prefrontal cortex — the brain's planning and decision-making center — while balancing. Instead, they displayed increased activity in areas controlling body awareness and movement, suggesting their balance control operated more automatically.
Activity in the prefrontal cortex increased in older adults even during simple balancing tasks, indicating their brains had to work harder to maintain stability. This extra mental effort suggests balance becomes less automatic and requires more conscious effort and control with age.
However, they also found that the aging brain maintains significant capacity for positive adaptation, as balance training produced measurable changes in brain structure. After 12 weeks of balance exercises, participants showed increased gray matter volume in motor control areas and better communication between brain regions.
So, the neural pathways controlling balance are highly adaptable. Interestingly, the study also found that balance training activated genes that control brain-derived neurotrophic factor (BDNF), a protein that supports existing neurons and encourages growth of new neural connections. This reveals a direct biological mechanism for how balance practice strengthens brain function, and training effects were remarkably consistent across age groups.
Despite starting with different baseline brain activity patterns, both older and younger adults showed similar rates of improvement in neural pathway development. This finding highlights the brain's lifelong ability to strengthen balance control through targeted exercise.13
Simple Balance Tests Reveal Hidden Health Risks
As reported by the Associated Press, simple home tests can predict fall risk and overall health with a great degree of accuracy. Dr. Greg W. Hartley, a University of Miami physical therapy professor, recommends a basic one-leg balance test to gain crucial insights into your health status and fall risk.14
The test is straightforward. Stand near a wall for safety, then lift one foot off the ground. "If you can balance on each leg for 10 seconds, you should be fine," explains Hartley. Those unable to maintain this position would benefit from professional evaluation.
Another assessment called "timed up and go" (TUG) measures functional mobility. The test involves timing how long it takes to stand from a chair, walk 10 feet, return, and sit back down. Times over 15 seconds signal very high fall risk, while completing the task in 12 seconds or less indicates minimal risk.15
Healthcare costs reveal the importance of prevention. Three million older Americans require medical care for fall injuries annually, according to the U.S. Centers of Disease Control and Prevention. However, Dr. Roopa Anmolsingh of the Cleveland Clinic emphasizes that falls are not inevitable with aging — they're preventable through proper assessment and intervention.16
The ideal time to start balance awareness begins at age 50. Even occasional unsteadiness warrants medical evaluation since balance involves multiple body systems. Problems could stem from blood pressure, medications, inner ear function, or nervous system issues.17
The good news is that even simple day-to-day activities offer opportunities for balance practice. For example, Anmolsingh recommends standing on one foot while waiting in line, sitting and standing without using armrests, and doing leg lifts in three directions while holding a counter for support.18
Simple Daily Exercises to Enhance Your Balance and Extend Your Life
In addition to the exercises already mentioned, here are several more. These exercises will activate multiple balance systems while strengthening the crucial connection between your brain and muscles. If you're just starting out, begin with exercises 1 to 3 and gradually add the others as your confidence grows.
Practice heel-to-toe walking as if on a tightrope — Take 20 steps forward, keeping your eyes fixed on a point ahead. This improves your brain's spatial processing and enhances coordination.
Perform supported squats while holding a chair — Keep your feet hip-width apart and lower yourself as if sitting down. Start with five repetitions and build up gradually.
Sit or kneel on a stability ball — Start with 30 seconds and increase your time as balance improves. This engages your deep core muscles and enhances overall stability.
Include gentle Tai Chi or yoga movements — These practices combine breathing, movement, and balance to enhance your overall coordination and spatial awareness.
Strengthen your ankles — Strong ankles are crucial for stability. Try writing the alphabet with your foot while seated, or practice rising up on your toes while standing.
Dynamic balance exercises — Try walking in different patterns — sideways, backward, or in a figure-eight — to challenge your dynamic balance.
Incorporate these exercises throughout your day. Try balance practice during TV commercials, ankle exercises while reading, or walking patterns when moving between rooms Start slowly and progress gradually. The goal is to challenge your balance, but always prioritize safety.
It's also worth noting that while 50 is considered the "ideal" age to start incorporating balance activities, it's never too early to start working on your balance. Incorporating these exercises into your routine at any age can help build a foundation for better balance as you grow older.
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Thank you for this insightful article. I'm a positive aging advocate focused on changing the outdated aging narrative to inspire people to move strong, stay sharp and age boldly. I invite you to subscribe to my Substack @webbieofwonder.
Also, sharing my Instagram reel about balance: https://www.instagram.com/reel/DFG17R1Sigf/