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Successful 10-second one-legged stance performance predicts survival in middle-aged and older individuals
  1. Claudio Gil Araujo1,
  2. Christina Grüne de Souza e Silva1,
  3. Jari Antero Laukkanen2,3,
  4. Maria Fiatarone Singh4,
  5. Setor Kwadzo Kunutsor5,6,
  6. Jonathan Myers7,
  7. João Felipe Franca1,
  8. Claudia Lucia Castro1
  1. 1 Exercise Medicine Clinic-CLINIMEX, Rio de Janeiro, Brazil
  2. 2 Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland
  3. 3 Central Finland Health Care District, Department of Medicine, Jyväskylä, Finland
  4. 4 School of Health Sciences and Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
  5. 5 National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK
  6. 6 Translational Health Sciences, Bristol Medical School, University of Bristol, Southmead Hospital, Bristol, UK
  7. 7 Cardiology Division, VA Palo Alto Health Care System and Stanford University, Palo Alto, California, USA
  1. Correspondence to Dr Claudio Gil Araujo, Clinimex Medicina do Exercicio, Rio de Janeiro 22031-071, Brazil; cgaraujo{at}


Objectives Balance quickly diminishes after the mid-50s increasing the risk for falls and other adverse health outcomes. Our aim was to assess whether the ability to complete a 10- s one-legged stance (10-second OLS) is associated with all-cause mortality and whether it adds relevant prognostic information beyond ordinary demographic, anthropometric and clinical data.

Methods Anthropometric, clinical and vital status and 10-s OLS data were assessed in 1702 individuals (68% men) aged 51–75 years between 2008 and 2020. Log-rank and Cox modelling were used to compare survival curves and risk of death according to ability (YES) or inability (NO) to complete the 10-s OLS test.

Results Overall, 20.4% of the individuals were classified as NO. During a median follow-up of 7 years, 7.2% died, with 4.6% (YES) and 17.5% (NO) on the 10-s OLS. Survival curves were worse for NO 10-s OLS (log-rank test=85.6; p<0.001). In an adjusted model incorporating age, sex, body mass index and comorbidities, the HR of all-cause mortality was higher (1.84 (95% CI: 1.23 to 2.78) (p<0.001)) for NO individuals. Adding 10-s OLS to a model containing established risk factors was associated with significantly improved mortality risk prediction as measured by differences in −2 log likelihood and integrated discrimination improvement.

Conclusions Within the limitations of uncontrolled variables such as recent history of falls and physical activity, the ability to successfully complete the 10-s OLS is independently associated with all-cause mortality and adds relevant prognostic information beyond age, sex and several other anthropometric and clinical variables. There is potential benefit to including the 10-s OLS as part of routine physical examination in middle-aged and older adults.

  • Physical Fitness
  • Aging
  • Frailty
  • Exercise

Data availability statement

Data are available on reasonable request. Deidentified data are available on reasonable request.

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Data availability statement

Data are available on reasonable request. Deidentified data are available on reasonable request.

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  • Correction notice This article has been corrected since it published Online First. The author's name, Setor Kwadzo Kunutsor, has been amended and affiliations have been updated.

  • Contributors CGA, CGSS, CLC and JFF were involved in the planning of the study and collecting data. Statistical analysis: CGA, CGSS, SK, JAL. Interpreting data: CGA, CGSS, MFS, JM, SK, JAL. Manuscript writing and revising: all authors. CGA acts as the guarantor of the study.

  • Funding CGA was partially sponsored by research grants from national and local governmental agencies. Partial financial support was provided by CNPq e FAPERJ research agencies.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting, or dissemination plans of this research.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.