Balance fades after 50, and a 10-second test shows where you stand

Key takeaways

• In a Brazilian study of 1,702 adults aged 51 to 75, about 1 in 5 couldn’t stand on one leg for 10 seconds, and their risk of dying over about seven years was 84% higher after accounting for age, sex, weight and existing illness¹.
• Your balance depends on three inputs, your eyes, your inner ear and sensors in your muscles, joints and feet, which your brain blends into one picture of where you are⁶.
• About 1 in 4 adults 65 and older, more than 14 million people, report a fall each year, and their fall death rate rose 21% from 2018 to 2024, according to the CDC³.
• A 2019 Cochrane review of 108 trials found that exercise cut the rate of falls in older adults living at home by 23%, with balance and functional exercise showing the clearest benefit⁹.
• You can check your balance at a kitchen counter and practice for five minutes a day, but see a clinician first if you’ve fallen, feel dizzy or feel unsteady when you walk⁶¹³.

Stand next to a kitchen counter. Raise one foot behind you and tuck its toes against the back of your standing leg, about calf height. Keep your arms down, fix your eyes on a spot ahead, and try to hold still for 10 seconds.

Researchers asked 1,702 Brazilian adults aged 51 to 75 to do exactly that during routine checkups, with up to three tries on either foot¹². About 1 in 5 couldn’t do it¹².

Over a median follow-up of seven years, 17.5% of those who failed died, compared with 4.6% of those who passed¹. After the team accounted for age, sex, body weight and existing illness, failing the test was still linked to an 84% higher risk of death¹.

The finding, published in the British Journal of Sports Medicine in 2022, doesn’t mean wobbling causes death¹². Those who failed started out in worse health. Type 2 diabetes, for instance, affected about 38% of them, versus roughly 13% of those who passed².

Still, the study shows something useful: balance is a skill that changes with age, and you can measure it at home with a timer and a counter to hold.

Your balance runs on three sensors and one processor

Standing still feels automatic, but it runs on a constant stream of data. The National Institute on Deafness and Other Communication Disorders (NIDCD) describes three main inputs⁶:

• Your eyes tell your brain where you are compared with the room around you.
• Your inner ear houses the vestibular system. Its semicircular canals register every turn of your head. Next to them, two small sacs called the utricle and saccule track which way is down and how your head moves forward, back, up or sideways. They rely on tiny grains of calcium carbonate resting on sensory hair cells⁶.
• Your muscles, joints and the touch sensors in your legs report where your body is and how it’s loaded. This body sense is called proprioception.

Your brain blends these signals and sends corrections to your muscles as you stand, walk or turn⁶. When muscles are weak or slow to respond, recovering from a stumble gets harder, and fall risk rises⁶.

If one input weakens, the others can cover for it. That’s why closing your eyes is so revealing: it makes the other two carry the load.

Balance trouble is common. In 2008, about 15% of American adults, or 33 million people, reported a balance or dizziness problem, according to NIDCD⁶.

Balance holds steady for decades, then drops

Aerobic fitness, strength and flexibility tend to slip earlier in adulthood, the Brazilian researchers point out. Balance stays fairly steady into the 50s and then falls off fast². Their own numbers trace that curve²:

Age	Share who couldn’t hold one leg for 10 seconds
51 to 55	About 5%
56 to 60	8%
61 to 65	Just under 18%
66 to 70	Just under 37%
71 to 75	About 54%

A 2007 study of 549 healthy adults aged 18 to 99, published in the Journal of Geriatric Physical Therapy, adds detail⁷. People stood barefoot on one leg with their arms crossed for up to 45 seconds, and the researchers kept each person’s best of three tries.

With eyes open, people in their 40s and 50s averaged about 41 to 42 seconds⁷. The average fell to about 32 seconds in the 60s, 21 seconds in the 70s and 9 seconds at 80 and older⁷.

With eyes closed, the drop came much sooner. Adults under 40 averaged about 15 seconds, people in their 40s about 13 and people in their 50s about 8⁷. By the 60s, it was about 4 seconds⁷. Men and women scored about the same⁷.

The lesson: your eyes can hide a decline that has already started, so an eyes-open test alone may not show a change until your 60s.

Falls are where lost balance costs the most

Balance matters most at the moment it fails. The Centers for Disease Control and Prevention (CDC) reports these figures for adults 65 and older:

• About 1 in 4 report a fall each year, more than 14 million people³. Less than half of those who fall tell their doctor⁴.
• Falling once doubles your chance of falling again⁴.
• Older adults’ falls lead to about 4.5 million emergency visits a year. About 3.1 million people are treated and released, and 1.4 million are admitted⁴.
• Nearly 319,000 older adults are hospitalized for hip fractures each year, and falls cause 88% of hip fracture emergency visits and hospital stays⁴.
• Falls are the most common cause of traumatic brain injury in this age group⁴.
• Falls kill about 41,000 older adults a year⁵.

The trend is heading the wrong way. The age-adjusted fall death rate for older adults rose 21%, from 64.7 per 100,000 in 2018 to 78.4 in 2024³.

There’s a quieter cost, too. The CDC notes that fear of falling can lead people to cut back on everyday activities, and that being less active leaves people weaker and more likely to fall⁴.

Not every fall is a balance problem. The CDC says most falls come from several risk factors acting together¹². We cover the others below.

A kitchen-counter balance check

This self-check is our own. It borrows the four stances from the CDC’s 4-Stage Balance Test, a clinic tool from the agency’s STEADI fall-prevention program, and adds steps from the studies above¹⁷⁸. It’s a snapshot, not a diagnosis.

Before you start:

• Stand at a kitchen counter or in a corner, with a sturdy chair behind you.
• Go barefoot on a non-slip floor or wear flat, closed shoes.
• Ask a partner to time you and stand close, if you can.
• Use the counter to get into each position, then let go and start the timer.
• If you need a cane or walker to get around, skip the home version and ask your clinician to run it. The CDC version is a clinic test done without the device⁸.
• You may move your arms or body to stay steady. Stop the timer if your feet move or you grab support. If you can’t hold a step for 10 seconds, stop there and skip the harder steps⁸.

Step	How to stand	Goal	What a miss may mean (our guide)
1	Feet side by side, touching	10 seconds	Talk to a clinician soon and skip the rest
2	Instep of one foot beside the big toe of the other	10 seconds	Ask about a balance assessment
3	Heel to toe, one foot right in front of the other	10 seconds	CDC treats a miss here as a sign of higher fall risk8
4	One foot, the free foot resting behind the other calf, arms at your sides	10 seconds	Tied to higher death risk in adults 51 to 751; worth raising with your clinician
5	Step 4 with eyes closed, partner beside you, counter in reach	Note your time	No pass mark; compare only with yourself

Track it. Write down your times and the date. Retest every month or two in the same shoes.

Don’t test alone if you’ve fallen in the past year, feel unsteady when standing or walking, or worry about falling. Those are the three screening questions in the CDC’s STEADI guide for clinicians, and a yes to any of them flags fall risk¹³. Ask your clinician to run the test with you.

Exercise cuts falls by about a quarter

A 2019 Cochrane review, led by Sherrington and colleagues, pooled 108 randomized controlled trials, studies that assign people by chance to exercise or to a comparison group⁹. Together they enrolled 23,407 people in 25 countries, with an average age of 76; 77% were women⁹.

Across those trials, people who exercised fell about 23% less often, and the reviewers graded that finding high certainty⁹. In everyday terms, a group of 1,000 older adults who would have had 850 falls in a year would instead have about 655⁹. Exercise also meant 15% fewer people had any fall at all⁹.

Not every kind of exercise had the same proof⁹:

• Balance and functional exercise, such as standing and stepping practice, cut falls by 24% (high certainty).
• Programs mixing several types, mostly balance plus strength work, cut falls by 34% (moderate certainty).
• Tai chi cut falls by 19% (low certainty) and the number of people who fell by 20% (high certainty).
• Walking, dance or strength training alone had too little evidence to judge.

Where side effects were reported, they were mostly minor muscle and joint complaints⁹. And the benefit showed up both in trials that recruited people at high fall risk and in trials that didn’t⁹.

Federal guidelines reflect this. The 2018 Physical Activity Guidelines for Americans ask older adults to do multicomponent activity, which means balance training along with aerobic and muscle-strengthening work¹⁰¹¹. The CDC’s examples of balance activities include walking backward, standing on one leg and using a wobble board¹¹. It adds that stronger back, belly and leg muscles help balance, too¹¹.

Walking has plenty going for it, but the trials can’t yet show that walking by itself prevents falls⁹. Balance needs its own practice.

A five-minute daily balance practice

This beginner routine is our own. It uses the kind of standing and stepping work that did best in the Cochrane review, at a gentle starting dose⁹. Do it at a counter, daily if you like. The programs that cut falls in trials were longer and harder; our upcoming guide to improving balance covers those.

How hard should it feel? Rate each hold on a 0-to-10 wobble scale. Zero means rock steady, and 10 means you have to grab the counter. Aim for about 4 to 6: you sway and correct but rarely need your hands. If you keep hitting 10, add support.

Minute	Move	How to do it	Easier	Harder
1	Sway in place	Feet together. Lean slowly forward and back, then side to side, without lifting heels or toes.	Feet a few inches apart	Arms crossed
2	Staggered stand	Instep of one foot beside the big toe of the other. Hold 20 to 30 seconds, then switch.	Both hands on the counter	Turn your head slowly side to side
3	Heel-to-toe stand	One foot right in front of the other. Hold 20 to 30 seconds, then switch.	Fingertips on the counter	Hands hovering just above it
4	One-leg stand	Lift one foot. Do 3 holds of up to 10 seconds on each leg.	Two fingers on the counter	Hands off, then a few seconds with eyes closed and a partner close
5	Heel and toe raises	Rise onto your toes 10 times, then lift your toes 10 times.	Both hands on the counter	Lower over a slow count of three

Change one thing at a time. Reduce hand support first, then lengthen holds, then add brief eyes-closed work.

Medicines, eyes, feet and rugs: the rest of the picture

Balance practice is one tool. The CDC’s STEADI program asks clinicians to check the other common risks¹²¹³:

• Medicines. Psychoactive drugs, meaning those that act on the brain, are a listed risk¹². STEADI calls for a medicine review and for stopping, switching or lowering doses of drugs that raise fall risk¹³. NIDCD also lists medicines as a cause of balance problems⁶. Bring every pill and supplement to that review.
• Eyes. Clinicians are asked to check vision, refer to an eye specialist when needed and consider cataract surgery¹³.
• Blood pressure when you stand. A drop in blood pressure when you get up can make you unsteady. NIDCD lists it as a cause of balance trouble, and STEADI asks clinicians to check for it⁶¹³.
• Feet and shoes. Foot problems count, and STEADI covers shoe fit, traction, insoles and heel height¹²¹³.
• Vitamin d. STEADI suggests a daily supplement for people who are low or likely low¹³.
• Your home. Missing handrails or grab bars, dim light or glare, clutter, and slippery or uneven floors all raise risk¹². An occupational therapist can do a home safety check¹³.

The body’s own balance system, trained by use

Natural-health thinking trusts the body to adapt when it gets the right challenge. Balance is a clear example. The sensors are built in, and the trials that worked gave people regular practice in using them⁹.

You don’t need to buy much. The programs that worked used standing, stepping and strength moves, and tai chi, a traditional practice, cut the number of people who fell⁹. Bring the same skepticism to a pricey balance gadget that you’d bring to a new drug.

One caution about the one-leg study: it was observational, meaning researchers watched people rather than assigning them to anything. People with poor balance may also be less active, smoke more or take more medicines, and the team couldn’t adjust for those².

Claim	What the research shows	Evidence level
Exercise prevents falls in older adults living at home	23% fewer falls across 108 trials, high certainty9	Strong evidence
Balance and functional exercise is a key ingredient	24% fewer falls, high certainty; 34% when combined with strength work, moderate certainty9	Strong evidence
Tai chi lowers the number of people who fall	20% fewer fallers, high certainty9	Strong evidence
Exercise prevents fall-related fractures	27% fewer people with fractures, low certainty9	Promising but early
Walking alone prevents falls	Too few trials to tell9	Not enough evidence
Failing the 10-second one-leg stand signals higher death risk	One observational study of white Brazilians, adjusted for age, sex, weight and illness but not activity or medicines12	Promising but early
Improving your one-leg time will lengthen your life	No trial has tested it	Not enough evidence

Questions readers ask

The bottom line

Balance is a skill your brain runs with your eyes, inner ear and body sense, and it tends to hold until your 50s before slipping. A careful one-leg check at a kitchen counter shows where you stand today, and exercise that challenges balance is one of the best-proven ways to prevent falls. Five minutes a day is a fine way to begin.

If you’ve fallen, feel unsteady or get dizzy, start with a clinician instead. A medicine review, an eye exam and a home safety check belong in the plan alongside any exercise.

Related reading

• Tai chi, prayer and journaling: what research can measure and what it can’t
• Vibration plates didn’t build bone in a year-long trial, though falls are another story
• Walking while talking tests your coordination, and you can practice it
• What happens when you don’t tell your doctor about supplements
• The symptoms that mean call 911 now

Sources

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2. University of Eastern Finland. “Inability to stand on one leg for 10 seconds in mid to later life linked to near doubling in risk of death within next 10 years.” News release, June 22, 2022. uef.fi
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10. U.S. Department of Health and Human Services. “Physical Activity Guidelines for Americans, 2nd edition: Executive Summary.” 2018. odphp.health.gov
11. Centers for Disease Control and Prevention. “What Counts as Physical Activity for Older Adults.” Updated December 4, 2025. cdc.gov
12. Centers for Disease Control and Prevention, STEADI. “Fact Sheet: Risk Factors for Falls.” 2017. cdc.gov
13. Centers for Disease Control and Prevention, STEADI. “Algorithm for Fall Risk Screening, Assessment, and Intervention.” 2019. cdc.gov
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15. Leeds Beckett University, Carnegie School of Sport. “Health screening guidance” (research ethics guidance based on ACSM’s Guidelines for Exercise Testing and Prescription, 10th edition). Undated, accessed October 2026. Www.Leedsbeckett.Ac.Uk