A Simple Step Test May Help Predict Longevity in Older Adults

Researchers at Ben-Gurion University of the Negev say that the speed of a single voluntary step, especially when an older adult is distracted, may help predict survival, independence, and overall functional health. The study, published in Gerontology, focused on balance, gait, and falls in older people, a problem the researchers describe as a major global burden.

Lead researcher Prof. Yitzhak Melzer said falls affect about 30% of people over 65 each year, and about 50% of those aged 80 and older. In Israel, he said, roughly 1,000 older adults arrive at emergency rooms every day because of a fall, sometimes with hip fractures. In the United States alone, he said, the annual cost is about $50 billion. He argued that the key challenge is not only treating falls after they happen, but identifying the 30% at highest risk early enough to intervene with exercise, medical adjustments, medication changes, or home modifications.

The study used data collected in Melzer’s lab between 2005 and 2011 from older adults who underwent balance and walking tests, including body sway while standing and a voluntary step test. Participants performed the step once normally and once while doing a Stroop task, which diverted attention with conflicting color-word cues. Fifteen years later, the researchers checked survival records and found that about half of the participants had died during follow-up.

The main finding was that slower reaction time in the dual-task step test predicted mortality. Each 0.1-second delay was associated with about a 28% higher risk of death during follow-up. Melzer said that, in the model, a person who stepped 0.1 seconds faster had an estimated survival advantage of about 2.9 months over 10 years compared with a slower peer.

He said the result matters because daily life constantly requires dual-tasking, such as walking and talking at the same time. The researchers note that the test may add useful information to standard clinical assessments, but they caution that the study shows an association, not proof that improving step speed itself extends life. Melzer said the team now wants to test larger samples in Israel and abroad, and he also pointed to a 2015 training study in which older adults improved balance and step speed, raising the open question of whether such gains could also improve survival.