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One-Leg Balance Test Emerges as Clear Signal of Physical Ageing – What It Means for Thailand’s Ageing Society

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A simple test—how long you can stand on one leg—may be one of the clearest indicators of your physical age and even your long-term health outlook, according to growing research in the field of geriatric medicine. New studies, including recent findings from the Mayo Clinic and data published in the British Journal of Sports Medicine, suggest that the ability to balance on one leg for at least 10 seconds is strongly linked to overall health and longevity, especially in people over 50. For Thais concerned about healthy ageing, this insight offers a powerful, easy-to-use predictor that could shape personal and public health strategies for years to come.

Balance is something we hardly think about until we start to lose it. Yet, as highlighted in a synthesis by Beatriz Carpallo Porcar and Rita Galán Díaz in The Conversation (2025), standing on one leg is no longer just a childhood game or a yoga pose but a valuable biomarker for healthy ageing. Specifically, a 2022 study spanning 1,702 older adults found that those unable to stand on one leg for 10 seconds had a two-fold increased risk of death within the next seven years. The Mayo Clinic’s newer study—including healthy adults over 50—confirmed that balance on the non-dominant leg declines with age and is a better predictor of neuromuscular ageing than even grip or leg strength, which have long been used as physical benchmarks (The Conversation).

Why should people in Thailand pay attention to this research? The Kingdom faces a rapidly ageing population, with over 20% of its people projected to be 60 or older by 2035 (Thai Elderly 2018 - Department of Older Persons). As Thais live longer lives, the question of how to age healthily and actively becomes central—not just for individuals, but for families, public health officials, and policymakers alike. Importantly, falls and complications due to poor balance are a top cause of injury and loss of independence among older Thai adults (PMC on falls among elderly in Bangkok). Simple home tests and community screening could help to shift the focus from treatment to prevention.

The science behind balance is both fascinating and complex. Maintaining your center of gravity, especially on one leg, requires the brain to constantly process feedback from your eyes (visual system), your ears (vestibular system), and your muscles and joints (proprioception). These systems send a real-time stream of information to your brain, which then triggers subtle muscle adjustments to prevent you from toppling. As we age, the ability of each system to perform declines; conditions like muscle loss (sarcopenia), chronic illness (diabetes, heart disease), and obesity can accelerate this process.

Research has long valued other measures, like grip strength and walking speed, but balance appears to be affected earlier and more significantly by the ageing process. A 2024 meta-analysis in community-dwelling elderly found that poor performance in balance tests (including single-leg stance) corresponds with increased all-cause mortality (PubMed). Thai studies echo this connection, relying on standard tools such as the Timed Up and Go (TUG) and Berg Balance Scale (BBS) to assess balance and predict fall risk in elders (Journal of Medical Association of Thailand - PDF). Notably, Thai reference values have been published for common strength and balance assessments, giving local clinicians a practical yardstick (PubMed - Reference values).

Quotes from prominent experts reinforce the gravity of these findings. Dr. Claudio Gil Araújo, a sports and exercise physician who led the 2022 British study, explained: “The single-leg stance is a quick and safe test, particularly for those 50 and older. Failing this test may be linked not only to impaired balance, but also to reduced lower limb strength and impaired brain function” (British Journal of Sports Medicine). Locally, Dr. Sarawut Chaimongkol, a public health researcher at Mahidol University, commented in a 2023 interview: “Thai families often do not recognize how dangerous a simple fall can be for our elders. Screening for poor balance provides an early warning and a chance to intervene” (he01.tci-thaijo.org).

For Thais, traditional lifestyles have long included “functional fitness” activities that support strength and balance, such as squatting, gardening, and temple cleaning. However, as urbanization and sedentary habits rise, younger and older Thais alike are losing opportunities for movement. Community-based exercise, especially via tai chi and yoga—both popular in many parts of Asia—can measurably improve balance, as confirmed by recent clinical trials (PLOS One). Notably, a 2025 clinical trial showed that personalized, progressive balance exercises delivered the best results for improving stability and preventing falls in older adults (PubMed).

Looking ahead, the implications for both public health and policy are significant. Community screening for balance, such as the single-leg stance test, could be implemented in sub-district hospitals (โรงพยาบาลส่งเสริมสุขภาพตำบล) and primary care settings with minimal cost but high impact. The Ministry of Public Health and the National Health Security Office could integrate balance screening into the annual health checkups already offered to seniors nationwide, utilizing trained volunteers or family caregivers for monitoring.

Culturally, it is important to communicate that maintaining balance is not a matter of luck or genetics alone. As the sayings go, “อายุยืนหมื่นปี ขอให้มีสุขภาพดีทุกปี” (“A long life is worthwhile only with good health”), which echoes the findings of geriatric science. Many elders can be empowered with simple guidance and encouragement to regularly practice balancing (ยืนขาเดียว), walk in straight lines, and integrate movement into daily life—be it through walking stick use, village dancing (รำวง), or mindful stair-climbing in Buddhist temples.

Future research may focus on how digital technology and telehealth can further empower Thais to self-monitor their balance—with smartphone apps guiding home-based tests or local health units providing remote physiotherapy. Moreover, further longitudinal studies in Thai populations could refine the cut-off points for balance decline and tailor interventions to local cultural and environmental contexts.

Practically speaking, what should Thai readers do? Adults—starting as early as age 40—should challenge themselves daily: stand on each leg (one at a time) for as long as possible, aiming for at least 10 seconds. If you wobble or fail, don’t be discouraged—but take it as a sign to incorporate more balance and strength exercises. Activities like yoga, tai chi, or simple leg raises while brushing teeth can go a long way. Families should encourage elders to check their balance regularly and consult health professionals if there is a steady decline or history of unexplained falls. Meanwhile, policymakers and community leaders should make balance screening and exercise promotion a health priority in schools, workplaces, and elder centers.

In the context of an ageing Thailand, maintaining balance—both physical and social—will be crucial for ensuring that longer lifespans are also healthier, safer, and more independent.

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Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.