Can you stand on one leg for ten seconds? This simple balance test can work as an indicator of death risk for up to ten years for people over 50 and should be included in routine checkups for older people.
The conclusion is drawn from a study published in the British Journal of Sports Medicine this Tuesday (21) that included four Brazilian researchers and others from Finland, the United States, the United Kingdom and Australia.
The research analyzed 1,702 people between the ages of 51 and 75 between February 2009 and December 2020. They are participating in a cohort study (Clinimex Exercise), created in 1994 to assess associations between various fitness measures with poor health And the dead.
The results show that the inability to stand on one leg for ten seconds, from the age of 50, is linked to an absolute risk of death 3.8 times higher (17.5% in the group that did not completed the test and 4.6% in what he completed). When adjusted for all clinical variables, such as gender and body mass index, the risk is nearly doubled (1.84).
“It’s a much bigger risk than having a diagnosis of coronary artery disease, being obese, hypertensive, or being dyslipidemic. So it’s a priority for the doctor to assess that ability as well.” [de ficar em uma perna só]“, says the main author of the research, the doctor Claudio Gil Soares de Araújo, director of research and education at Clinimex (Clinic of Exercise Medicine).
Araújo says that in his clinical experience, with more than 4,000 patients seen, the oldest person to complete the balance test was 91 years old. At the other end, the youngest who failed was 38.
“Balance and other components of fitness, like aerobic or non-aerobic, need training, especially when we start losing, that is, in the sixth decade of the life.”
The study is observational and as such cannot establish a causal relationship. Another limitation is that information on factors that may influence balance, such as recent history of falls, physical activity levels, diet, smoking, and medication use, was not assessed at the time. work.
According to Araújo, one of the hypotheses that would explain the higher mortality risk is that people with balance problems are more prone to falls. Fall fractures are responsible for approximately 70% of accidental deaths in people over the age of 75.
In Brazil, there are more than 600,000 femur fractures per year, 90% of which result from falls. The WHO (World Health Organization) has established June 24, next Friday, as World Fall Prevention Day.
According to orthopedist Jorge dos Santos Silva, president of the SBO (Sociedade Brasileira de Ortopedia), the Covid-19 pandemic in all its aspects has contributed to a greater weakening of the elderly, especially those over 80 years old. “Fragile older people are more likely to fall and fracture.”
Geriatrician Maísa Kairalla, coordinator of the Outpatient Care Transition Clinic in Geriatrics and Gerontology at Unifep (Federal University of São Paulo), says that the clinics are full of frail elderly people and that a simpler tool, such as the test of balance proposed in the study, can be of great value for health professionals.
“Especially in so many places where there is no time to do a better assessment of muscle strength and balance. Or until it can be done via telemedicine. If the person is already poor on a simple test, you can assume that she won’t be able to do more complex tests and that deserves immediate attention,” he says.
There is no data in the study published in the BMJ that demonstrates that by improving balance, the risk of falling or death will be changed. “But we can assume so. The simple fact of reducing the risk of falling will already be a protective factor and capable of prolonging survival,” says Claudio Araújo.
The aim of the study was to demonstrate that a simple and safe balance test can be a reliable indicator of risk of death and, as such, deserves to be included in routine testing of the elderly.
In total, 1 in 5 (20%) study participants failed the test. The inability to do so increased with age. The proportions unable to stand on one leg for ten seconds were: nearly 5% aged 51-55; 8% between 56 and 60; 18% between 61 and 65; and 37% between 66 and 70 years old.
More than half (54%) of people aged 71 to 75 did not pass the test. In other words, people in this age group were more than 11 times more likely to fail the test than those just 20 years younger.
During an average follow-up period of seven years, 123 (7%) people died: cancer (32%); cardiovascular diseases (30%); respiratory disease (9%); and complications of Covid-19 (7%).
But no association between these deaths and balance test scores has been established.
In general, those who failed the test were in poorer health: a greater proportion of them were obese and/or suffered from heart disease, high blood pressure and an unhealthy blood lipid profile. Type 2 diabetes was three times more common in the group that failed the test: 38% versus 13%.
Another limitation of the study, according to the researchers, is that since the participants were all white Brazilians, the results might not be more broadly applicable to other ethnicities and nations.
A word of advice from the lead author of the study: Seniors should be careful if they decide to do the self-balancing test. “Be close to a sturdy wall or table so you can lean on if you lose your balance or have someone nearby.”
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