Your sense of balance fades after 40—but it doesn’t have to. Here’s how to maintain it .

If you can’t comfortably stand on one leg for 10 seconds, your body may be trying to tell you something. “Being able to stand on one leg is one of the most predictive measurements for aging,” says Clayton Skaggs, founder of the Central Institute for Human Performance (CIHP), the Karel Lewit Clinic, and Curious Gap Labs.

A 2024 Mayo Clinic study found that the ability to maintain balance standing on one leg indicates how well a person is aging more than strength or gait. Not only does it let us in on someone’s neuromuscular health, but it can also be a signal of other ailments.

“We utilize [balance] diagnostically to rule in or rule out other diseases,” says Paraminder Padgett, a neurological clinical specialist and physical therapy clinical supervisor at Dartmouth Hitchcock Medical Center. “We know inactivity can lead to poor balance, but problems in the brain can also lead to poor balance. One of our jobs is to help tease that out.”

That’s because a wide range of chronic conditions—diabetes, arthritis, multiple sclerosis, Parkinson’s, Alzheimer’s—can quietly erode your balance over time. Some affect nerves and proprioception, while others disrupt cognitive function and decision-making, all of which affect stability.

So while standing on one leg with your eyes closed might seem like a silly test, it’s actually a surprisingly comprehensive check-in. Balance is a complex, full-body symphony involving your eyes, ears, joints, muscles, and brain. Yet after age 40, these systems slowly decline due to the sedentary lifestyle many Americans ease into.

The result? A gradual loss of stability that can have serious consequences down the line: falls, fractures, and a shrinking world as people avoid movement they no longer trust. In 2021 alone, accidental falls caused 38,000 deaths among Americans over age 65. But here’s the hopeful part: it doesn’t have to be that way.

What balance depends on—and what starts to fade
Good balance depends on the integration of our vision, somatosensory system (responsible for the sensory information of touch from our muscles, joints, skin, and fascia), and vestibular system within our ears. When any of these systems start to slip, your sense of equilibrium can go with it.

“Just like we have wrinkles on the outside of your body, you have wrinkles on the inside,” Padgett says. “If you use it right, the systems in the brain will continue to adapt to that degradation.”

In other words, use it or lose it. However, Skaggs says we don’t necessarily need to expect these systems to dwindle as we reach the magic age of 40. “These concepts of variation are misinterpreted relative to folks just not taking care of their health,” he says. While some physical decline is natural—like changes in muscle mass, joint mobility, or sensory precision—what we think of as “normal aging” is often a reflection of long-term neglect.