Struggling to balance on one leg for 20 seconds or
longer was linked to an increased risk for small
blood vessel damage in the brain and reduced
cognitive function in otherwise healthy people with
no clinical symptoms, according to new research in
the American Heart Association's journal Stroke.
"Our study found that the ability to balance on one
leg is an important test for brain health," said
Yasuharu Tabara, Ph.D., lead study author and
associate professor at the Center for Genomic
Medicine at Kyoto University Graduate School of
Medicine in Kyoto, Japan. "Individuals showing poor
balance on one leg should receive increased
attention, as this may indicate an increased risk
for brain disease and cognitive decline."
Tabara study - Man standing on one leg. To measure one-leg standing time, participants stood with their eyes open and raised one leg. Copyright Yasuharu Tabara, Kyoto University Graduate School of Medicine.
The study consisted of 841 women and 546 men,
average age of 67. To measure one-leg standing time,
participants stood with their eyes open and raised
one leg. The maximum time for keeping the leg raised
was 60 seconds. Participants performed this
examination twice and the better of the two times
was used in the study analysis. Cerebral small
vessel disease was evaluated using brain magnetic
resonance imaging.
Researchers found that the inability to balance on
one leg for longer than 20 seconds was associated
with cerebral small vessel disease, namely small
infarctions without symptoms such as lacunar
infarction and microbleeds.
They noted that:
34.5 percent of those with more than two lacunar
infarction lesions,
16 percent of those with one lacunar infarction
lesion,
30 percent of those with more than two microbleed
lesions and
15.3 percent one microbleed lesion, had trouble
balancing.
Overall, those with cerebral diseases were older,
had high blood pressure and had thicker carotid
arteries than those who did not have cerebral small
vessel disease. However, after adjustment for these
covariates, people with more microbleeds and lacunar
infarctions in the brain had shorter one-legged
standing times. Short one-legged standing times were
also independently linked with lower cognitive
scores.
Although previous studies have examined the
connection between gait and physical abilities and
the risk of stroke, this is among the first study to
closely examine how long a person can stand on one
leg as an indication of their overall brain health.
Small vessel disease occurs due to microangiopathy
of arterioles in the brain, making these arteries
less flexible, which can interfere with blood flow.
Small vessel disease typically increases with age.
Loss of motor coordination, including balance, as
well as cognitive impairment has been suggested to
represent subclinical brain damage. Tabara and
colleagues also found a strong link between
struggling to stand on one leg and increased age,
with marked shorter one-leg standing time in
patients age 60 and over.
Although the study did not assess participants'
histories of falling or physical fitness issues,
such as how fast they could walk or any gait
abnormalities, Tabara said the one-leg standing test
is an easy way to determine if there are early signs
of being at risk for a stroke and cognitive
impairment and whether these patients need
additional evaluation.
For more information
American Heart Association
Stroke, December 2014
Association of Postural Instability With
Asymptomatic Cerebrovascular Damage and Cognitive
Decline: The Japan Shimanami Health Promoting
Program Study.
Yasuharu Tabara, Yoko Okada, Maya Ohara, Eri Uetani,
Tomoko Kido, Namiko Ochi, Tokihisa Nagai, Michiya
Igase, Tetsuro Miki, Fumihiko Matsuda, and Katsuhiko
Kohara.
DOI: 10.1161/STROKEAHA.114.006704
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