Balance may be the missing piece in healthy aging

Balance is increasingly being recognised as a key part of fitness and healthy aging as it can help older adults prevent falls, while helping younger people improve athletic performance and avoid injuries.

Suppose, you're standing on one leg in your living room, the other stretched behind you, arms extended to the sides like a child pretending to be an airplane. The exercise seems ridiculously easy until you close my eyes. Your legs wobble, your ankles quiver, you sway from side to side and eventually topple forward, according to a recent article published by the Los Angeles Times..

The single-leg exercise is designed to test balance, but it may also reveal something about longevity.

A 2022 study published in the British Journal of Sports Medicine found that people aged 51 to 75 who could not stand on one leg for at least 10 seconds had an 84% higher risk of death within the following decade.

A 2024 Mayo Clinic study similarly found that the ability to maintain balance on one leg was a strong indicator of neuromuscular aging, outperforming measures such as strength and gait.

Why balance matters

For years, cardio, strength training and stretching have dominated discussions about fitness and longevity. Balance is now emerging as another important pillar of healthy aging.

Mike Teater, director of balance education at Fyzical, says balance can predict longevity partly because falls can trigger a chain reaction: injury can lead to reduced mobility, lower confidence and less activity, increasing the risk of chronic disease, social isolation, depression and cognitive decline.

Falls are a major public health concern among older adults. The US Centers for Disease Control and Prevention says one in four adults aged 65 and older falls each year, with falls the leading cause of injury-related death in this age group.

But declining balance is not simply an inevitable part of aging, says Kristal M Riska, a Duke University balance researcher and president of the American Balance Society.

"As we get older, we attribute balance problems to 'oh, that's just aging' - and certainly there are age-related changes - but that doesn't mean we can't intervene," Riska says.

Balance matters at every age

Balance is not just for older adults. It can help younger people and athletes improve performance, prevent sports-related injuries and stay fit.

Strength and balance also support each other. Strong muscles help maintain stability and mobility, while good balance can prevent movement patterns that contribute to injuries. This is particularly relevant for people whose jobs involve frequent movement, such as delivery drivers, teachers, caregivers and food-service workers.

Exercise physiologist Rachelle Reed says good movement quality and neuromuscular feedback - the brain's awareness of where the body is in space - can help prevent injuries caused by sudden movements or misjudged reaches.

What keeps us upright?

Balance depends on several systems working together: sight, the vestibular system in the inner ear and proprioception, or the body's awareness of its position in space.

Closing your eyes during a balance exercise makes it harder because the brain has fewer sensory cues. Standing on an uneven or soft surface can also challenge proprioception.

Balance also requires coordination between the brain, nerves and muscles, along with sufficient strength and healthy joints. A strong core, legs and ankles all contribute to stability.

Kimberly M. Burbank, a UCLA Health sports medicine physician, describes balance training as "almost like brain training" because it requires multiple systems to work together.

Balance can decline faster than strength as people age, particularly as eyesight, touch, strength and vestibular function deteriorate. Feeling unsteady, becoming more concerned about falling or relying more on walls and furniture for support can all signal declining balance.

That is why experts recommend starting balance training early and continuing it with age.

How to train your balance

Balance can be improved through activities such as yoga and surfing, while older adults may benefit from structured programmes such as the Otago Exercise Program, which combines progressive strength and balance exercises with walking.

Balance training should complement, not replace, regular exercise. Adults still need aerobic activity, stretching and strength training. The CDC recommends 150 minutes of moderate-intensity exercise or 75 minutes of vigorous exercise each week, along with muscle-strengthening activities at least twice a week.

Balance exercises themselves do not need to be complicated. Five one-minute exercises, three to four times a week, can be added to a workout or done at home.

Try standing on one leg for 30 seconds while watching television, then switch legs. Or practise walking heel-to-toe while waiting for a ride.

"You're retraining the neuromuscular system," Burbank says. Improvement may take three to six months, but consistent practice can help build a stronger baseline.

The first step is to test your "balanced IQ" and find out where you stand. From there, simple exercises can help you build and maintain better balance.