How Healthy Is Your Brain? Take This Test to Find Out

How long can you stand on one foot? This isn’t just a test of balance — it’s a test of brain health. (Tom and Steve/Photographer’s Choice RF/Getty Images)

Internet brain games aren’t the only way to gauge what’s going on between your ears. A simple physical test may be able to tell you how healthy your brain is, according to a new study from Japan, published in the journal Stroke.

In the study, researchers had 1,387 healthy people stand on one leg with their eyes open for as long as possible, up to a minute. Then they performed MRI’s on the subjects, whose average age was 67, and had them complete four cognitive tests.

Interestingly, the length of time the people could balance predicted what the scientists saw on the brain scans: Those who were unable to stand flamingo-style for more than 20 seconds were more likely to have cerebral small vessel disease, a condition where tiny blood vessels deep in the brain are damaged. None of the study participants showed any symptoms.

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Specifically, 16 percent of folks with one lacunar infarction lesion — a small, damaged area of the brain where a blood vessel has clogged — struggled to balance. About a third of those with more than two of these lesions had trouble standing on one foot. Likewise, 15 percent of people with one microbleed brain lesion — a minor hemorrhage due to a damaged vessel — and 30 percent with more than two such lesions had poor balance.

These trouble spots in the brain are what Richard Senelick, M.D., a neurologist and medical director of the HealthSouth Rehabilitation Institute of San Antonio, calls “silent” strokes. “You have tiny little blood vessels throughout your brain — they’re microscopic,” he says. “They can close off, and you get little damaged areas of the brain, but no symptoms.” They’re more common in people who are older or who have hypertension (particularly if it’s uncontrolled) or diabetes.

“If you get enough of these, you can actually get a [type of] dementia, called a vascular dementia,” Senelick says. In the study, short standing times were independently associated with poorer performance on the cognitive tests.

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So why the difficulty balancing?

Previous research has shown a link between “gait dysfunction” — that is, an abnormal way of walking — with brain lesions and blockage of small vessels. This study suggests that one component of gait — balance — may be especially tied to brain health, possibly because it reflects early brain changes that don’t necessarily cause symptoms, but increase risk of stroke. “One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities,” lead study author Yasuharu Tabara said in a statement.

However, Senelick cautions against automatically concluding you face an elevated risk of stroke if your balance is poor. As you age, your vision can become cloudy, your hearing may decline, your joints stiffen, and your proprioception (your sense of where your body is in space) worsens — all factors that may affect your ability to stand on one leg for a long time. (In fact, in the study, older participants had more trouble balancing.)

“Unless your check for all these other things, [this test] doesn’t predict your risk for having a stroke,” Senelick says. However, it does suggest you may need to seek evaluation — or as Tabara said, “Individuals showing poor balance on one leg should receive increased attention, as this may indicate increased risk for brain disease and cognitive decline.”

Flunk the test? Ask your doctor if you should be concerned, and take a proactive approach to brain health. “People say, ‘What can I do to keep from getting Alzheimer’s? What can I do to prevent stroke? If it’s good for your heart, it’s good for your brain,” says Senelick. “Work on your risk factors: hypertension, diabetes, poor diet, lack of exercise, smoking.” 

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