Researchers from Ben-Gurion University of the Negev (BGU) in Beersheba have found that how fast an older adult can take a step, one foot in front of the other – especially when distracted by a cognitive task at the same time – can serve as a valuable predictor of how long they will live.
With the growing elderly population, predicting survival through clinical examinations has attracted considerable interest.
The research was led by Prof. Itshak Melzer from BGU’s physical therapy department, together with colleagues Ofri Gans-Or, Anat Reiner-Benaim, and Iuly Treger from BGU and Soroka University Medical Center.
It was done in collaboration with Lars Oddsson from the University of Minnesota and RxFunction Inc., a Minnesota-based medical device company that designs and markets technologies that improve balance, increase mobility, and reduce the risk of falling.
Their findings have just been published in the journal Gerontology, under the title “Speed of voluntary step execution may predict survival among older adults: An explorative study.”
Melzer has a broad background in the study of balance control and falls in older adults. As a postdoctoral fellow at Boston University, he conducted a randomized controlled trial to test whether specific balance training could improve balance in older adults.
Faster stepping may help predict longer life, Ben-Gurion study finds
The team developed the first prototype of the BaMPer system, a balance perturbation system that could be an effective tool for measuring one’s ability to respond rapidly when balance is unexpectedly lost while recovering, providing a window into an individual’s long-term functional health.
It stimulates the nervous system and forces the body to develop quick, automatic reactions to prevent a fall,” Melzer told The Jerusalem Post in an interview.
While medical care usually measures life expectancy through chronological age or the number of chronic illnesses, physical indicators like walking speed seem to be strong indicators of health and independence.
The research team sought to expand this clinical toolkit by evaluating whether postural sway (static balance) and voluntary step execution (dynamic balance) could predict survival rates over a long-term follow-up period.
They stood on a force platform – a biomechanical instrument equipped with sensors that measure ground reaction forces and the center of pressure when a patient stands, walks, or performs movements.
It involves significant challenges, such as the need for a force platform in clinical settings, he said, but new technologies including wearable systems that can reliably detect step behavior could solve this problem.
The team analyzed balance data from 120 elderly participants, divided into two age groups – below 75 years of age and over 75 years living in the community – and found a significant link between step initiation latency and risk of death.
Participants in the dual-task setup were asked to take rapid steps while simultaneously performing a modified Stroop task, naming the ink color of words printed in mismatched colors. For example, seeing the word “blue” that was printed in green.
The researchers noted that because sensory detection and basic nerve conduction speeds remain constant between simple and distracted stepping, any delay in initiating a step during the mental challenge is largely driven by limitations in central neural processing.
Traditional static balance measures, such as an increase in anterior-posterior postural sway velocity (a sign of impaired balance), show a heightened risk of falls.
When this occurs, the central nervous system quickly corrects posture while standing barefoot with eyes closed. It can also predict the risk of death in a relatively shorter time. However, this was less effective and accurate than the dynamic stepping tests.
Health insurers can buy the equipment and test their elderly members, suggested Melzer, who has established strong ties with health funds and assisted-living facilities.
Slow stepping often means a decline in daily mobility that can trigger a cycle of reduced physical activity, overall deconditioning, and systemic health risks.
Because a voluntary step test is straightforward to conduct and requires minimal professional specialization, it could serve as an accessible indicator of functional vitality in clinical environments, the researchers said.
“Incorporating dual-task-based assessments into standard clinical evaluations could significantly improve survival prediction and help guide early interventions targeting cognitive-motor health,” Melzer noted.
“We tested people in the lab who were 80 and checked if they were still alive 20 years later; not many survived,” he recalled. “When we looked at the Health Ministry’s registry, if they died and when, we found that those who stepped faster than 100 milliseconds lived over a year longer on average than those who were slower.”
To improve your condition and live longer, do balance training – simple, targeted movements like the single-leg stand, heel-to-toe walk, and chair squats that strengthen core and lower-body muscles.
Always use a sturdy chair or wall for support, and aim for a few minutes of daily practice. Weight-bearing exercise while standing is also beneficial.
“It’s never too late to improve balance, but one must always consult a physician before starting to exercise at this age. We will study it with more people and follow up,” he asserted.
The study revealed that for every 100 milliseconds’ increase in step initiation time under dual-task (distracted) conditions, the risk of mortality increased by 28%.
In other words, older adults who required an additional 100 milliseconds to initiate a step while simultaneously performing a cognitive task were at a significantly greater risk of death during the follow-up period. This means that slower step initiation can serve as an indicator of reduced overall neurological and physiological resilience in aging.
They concluded that “crucially, because voluntary stepping speed is a modifiable trait that prior clinical trials have shown can be improved through targeted perturbation and balance rehabilitation training, these diagnostic measures offer a practical pathway to identify individuals who could benefit from specialized mobility programs to potentially extend longevity.
“Future studies should explore the longitudinal impact of voluntary stepping on survival, assessing whether cognitive-motor training for balance rehabilitation can enhance survival rates.”
Our muscles do what the brain tells them to do, Melzer continued.
“The brain is the big computer that gives orders and the timing, what works first and second, and how much muscles have to contract,” he said.
Asked how the elderly can reduce their risk of falling, Melzer advised “not talking when you walk. We know that drivers who talk on their phones have a much slower reaction time. But you can’t easily stop people from talking.”
Asked what the most common misunderstanding people are likely to have when they hear about the research, Melzer said that it was a pilot study, based on statistics.
“We need to test and follow up with a larger group. And our results showed averages – not predictions of individual patients. There are people who are slowest and will not die prematurely. Those who are fastest mustn’t think they’ll live forever,” he concluded.
Source:
www.jpost.com
