• How balance was measured — The participants underwent balance testing under two conditions — standing quietly with eyes open and with eyes closed. Their sway was recorded in millimeters, both side-to-side (lateral) and forward-backward (anterior-posterior). These measurements were analyzed alongside other clinical data, including blood pressure, body weight, and medication use.

• Lateral sway was a consistent predictor of CVD — Participants who swayed more from side to side during balance tests were more likely to be hospitalized for heart attack, stroke, or angina in the years that followed. For every 1 millimeter of added lateral sway during the test with eyes open, the risk of developing cardiovascular disease increased by about 1.4%. The risk rose by about 1.5% per millimeter when the test was done with eyes closed.

• The more you sway, the higher your risk — The results showed that participants in the top quarter for lateral sway had a significantly higher rate of cardiovascular events compared to those in the lowest quarter. This means that even small increases in sway added up to a meaningful difference in future health outcomes.

• Unsteady forward-backward movement mattered too — Among those tested with eyes closed, people who had faster and more erratic movement in the forward-backward direction were also more likely to develop CVD. These patterns reflected instability that wasn’t visible during regular medical visits.

• Balance testing outperformed some traditional risk markers — Side-to-side sway, especially during eyes-closed tests, ranked among the four strongest predictors of cardiovascular disease, along with being male and taking medications for high blood pressure or clot prevention. These four factors together explained 61% of the risk across the population. Balance alone accounted for about 10% of that risk.

• The results were consistent and reliable — Even after removing participants with very short follow-up periods, the findings didn’t change. Just 1 millimeter more sway still raised the risk of cardiovascular disease by up to 1.8%, depending on test conditions.

• Balance testing predicted future dementia — Those who showed balance impairment at age 66 had significantly higher rates of new-onset dementia compared to those with normal balance. The dementia rate was more than twice as high in those who could stand on one leg for less than 10 seconds versus those who could hold the position for 20 seconds or longer.

• Higher risk of both Alzheimer’s and vascular dementia — Participants with poor balance faced an 83% higher risk of all-cause dementia compared to those with normal balance. Their risk of Alzheimer’s disease was 80% higher, and the risk of vascular dementia was almost three times higher.

• Shorter balance time meant higher dementia risk — Even small reductions in balance performance showed a continuous, stepwise relationship with dementia risk. People in the “cautious” category (10 to 19 seconds of one-leg standing) still had a 28% higher dementia risk compared to those who could balance for 20 seconds or longer.

• White matter damage and cortical atrophy may explain the link — Poor balance was associated with structural brain changes often seen in early cognitive decline, including white matter lesions and gray matter atrophy in regions tied to motor and memory functions. These changes weaken both physical and cognitive processing, reducing adaptability in daily life.

• Microvascular disease contributes to cognitive and motor decline — Vascular-related damage in the frontal-subcortical circuits (which regulate movement and decision-making) explains why balance issues often accompany executive dysfunction, slowed thinking, and increased dementia risk. These shared neural pathways suggest that the same biological disruptions that undermine stability also degrade cognition.

• A non-cognitive early marker for dementia — Because balance testing is simple, noninvasive, and predictive, the authors propose it as a valuable screening tool for identifying dementia risk in older adults, especially in those who have not yet shown signs of cognitive impairment.

• Impaired balance predicted up to a threefold increase in dementia risk — Older adults who struggled to maintain a semi-tandem stance (standing with one foot slightly ahead of the other, heel beside toe) had a two to three times higher risk of developing dementia compared to those with stable balance.

• Slower walking speed signaled significantly elevated risk — Participants with slower gait at baseline had a 52% to 73% greater likelihood of dementia onset. The walking test, long known for predicting frailty and mortality, also proved to be a powerful early marker of cognitive decline.

• Lower limb strength mattered too — Poor performance on the chair stand test, an indicator of leg strength and neuromuscular coordination, was linked to a 56% higher risk of dementia. This adds to growing evidence that physical frailty and cognitive deterioration share overlapping biological pathways.

• Risk consistent across sex, age, and genetic risk — The associations were consistent regardless of participant sex, age, or presence of the APOE ε4 gene, a major genetic risk factor for Alzheimer’s. These findings support the role of motor testing as a universal tool for early dementia screening.

• Standing on one leg — Dr. Greg W. Hartley, a physical therapy professor at the University of Miami, recommends a simple balance test that involves standing on one leg for 10 seconds. If you’re able to hold it without wobbling, you're likely within a safe range. Struggling with the test, however, is a signal to seek medical evaluation.

For more insight into what one-leg balance tells you about your health, check out “Balancing on One Leg Reveals Important Clues About Your Neuromuscular Health.”

• Timed walking tests gauge — The “timed up and go” test (TUG) offers a quick check of your functional balance. You rise from a chair, walk 10 feet (3 meters), turn around, walk back, and sit down. You should ideally complete this in under 12 seconds. Taking more than 15 seconds marks impaired balance.

1. Walk heel-to-toe like you’re on a tightrope — Take 20 slow, deliberate steps in a straight line, placing the heel of one foot directly in front of the toes of the other. Keep your arms relaxed and your eyes fixed on a point ahead. This improves your brain's spatial processing and enhances coordination.

2. Do chair-supported squats — Stand with your feet hip-width apart. While you’re holding the back of a chair, lower yourself as if sitting down. Begin with five reps and increase gradually.

3. Use a stability ball — Sit or kneel on a stability ball for 30 seconds, adding time as your balance improves. This activates deep core muscles and builds full-body stability.

4. Perform gentle Tai Chi or yoga — You don’t need to join a class. Just a few minutes of slow, controlled breathing and movement done at home is enough. These practices blend breathing, movement, and balance to improve coordination and body awareness.

5. Build ankle strength — Weak ankles cause instability. Sit in a chair and try writing the alphabet in the air with your foot. Strengthen your ankles by tracing the alphabet with your foot while seated or doing toe raises while standing.