How long can you stand on one foot? The answer may predict your fall risk.

How long you can stand on one leg — specifically, your nondominant leg — is a telltale sign of age-related decline, according to a study led by researchers at Mayo Clinic.

Researchers found that a person’s ability to balance on one leg deteriorated with age faster than measurements of walking gait, grip, and knee strength. Participants, ages 52 to 83, were compared with each other in a cross-sectional study.

“If you have poor balance, you’re more likely to fall,” said Kenton Kaufman, the senior author of the study and a musculoskeletal research professor at Mayo Clinic in Rochester, Minn.

The ability to balance on one leg is “an important predictor” of someone’s risk of falling, he said.

“If you can’t stand on your leg for five seconds, you’re at risk of falls,” Kaufman said. “If a person can stand on their leg for 30 seconds, they’re doing really well, especially if they’re older.”

More than 1 in 4 people ages 65 and older fall every year, according to the National Institute on Aging. It is a leading cause of injury and injury-related death for older adults.

On average, the study’s participants could stand on their nondominant leg for 17 seconds. Among participants older than 65, the average was 11 seconds.

- The researchers recruited 40 healthy men and women who live around Rochester. Half of the participants were 50 to 65 years old; the rest were older than 65.

- Participants completed a series of tests measuring their balance, walking gait, grip, and knee strength. Researchers controlled the results for body size (weight and height) to determine if there were age-related changes.

- During balance tests, participants stood on a platform that measured how much they shifted their weight. They stood on both feet with eyes open, then eyes closed. Next they stood on their dominant leg, then their non-dominant leg with eyes open for up to 30 seconds.

- Researchers told participants to balance on one leg in whatever way they prefer. Results included how long they could stand on one foot and how much they shifted their weight.

The study published in PLOS One.

Our balance comes from several sensory inputs: our vision, specialized nerve receptors in the muscles and joints sensitive to movement, and, also, structures in our inner ear that help us determine our orientation in space.

“As we start to age, what happens is all of these systems start to degrade,” said Devin McCaslin, chief of audiology and otorhinolaryngology at the University of Michigan. “They’re all contributing in one way or another.”

The inner ear’s sense of balance can deteriorate over time because of exposure to loud noises — in the same way someone can develop hearing loss, McCaslin said.

“As people get older, the changes in the inner ear of balance and the brain makes it harder for them to maintain balance,” he said. “It really pops up in challenging environments, like walking in the dark.”

Jay Hertel, the chair of kinesiology at the University of Virginia, said the reason a decline in balance among older adults is a concern is because falls can be dangerous.

“We want to have older individuals maintain and train their balance so that they’re more resistant to suffering falls,” he said.

The researchers conducted a cross-sectional study, measuring participants’ data at a single point in time rather than a longitudinal study, which follows participants for years, or decades, to monitor for potential age-related decline.

Kaufman said another limitation of the study is the sample size of 40 participants. He said more participants would make the study more robust.

Lyndon Joseph, an exercise physiologist in the division of geriatrics and clinical gerontology at the National Institute on Aging, said more research is needed to better understand how clinicians could make use of this balancing test.

“To really validate this, it’s probably going to have to be done in a larger population,” Joseph said. “But this is an interesting start.”

Hertel said it’s “a great study” because researchers don’t often assess balance, gait, and strength at the same time. But he said he would have been interested in seeing more challenging gait assessments for the participants, such as walking while counting backward from 100 by threes.

Claudio Gil S. Araújo, the director of research and education at Clinimex, an exercise medicine clinic in Rio de Janeiro, said the study reinforces the idea that balancing on one leg is a simple tool clinicians can use to evaluate a person’s balance.

In a 2022 study of 1,702 adults, Araújo and a team of researchers found the inability to stand on one leg for 10 seconds was associated with a higher risk of death from any cause within seven years.

People start to lose their balance at about 60 years old, Araújo said. For people younger than that, flexibility is a better marker of aging.

Experts say regular exercise is key to improving balance. Tai chi, specifically, can improve balance in older adults, Kaufman said.

People can incorporate balancing into daily routines, for example, standing on one leg as you’re brushing your teeth, switching legs halfway through, Araújo said. Or when you reach to open a door, hold the doorknob and balance for 10 seconds on one leg.

Kaufman practices standing on one leg every week to maintain his balance.

“Some days, I’m able to go for the full 30 seconds, and some days, I don’t,” he said. “But at least I’m practicing.”