New evidence recently found that many ER doctors fail to recognize signs and symptoms of a stroke, which can leave patients at a higher risk for a potentially life-threatening "brain attack." Although patients should still rely on their physician for a complete cognitive and cardiovascular checkup, they should also be wary of their own warning signs. A study published in the American Heart Association’s journal Stroke has revealed a patient’s ability to stand on one leg can determine their risk for a stroke.

"One-leg standing time is a simple measure of postural instability and might be a consequence of the presence of brain abnormalities," Dr. Yasuharu Tabara, associate professor at the Center for Genomic Medicine at Kyoto University Graduate School of Medicine in Kyoto, Japan, said in a statement.

Tabara and his colleagues recruited 841 women and 546 men at an average age of 67. Participants were asked to stand on one leg with their eyes open for a maximum of 60 seconds. This examination was performed twice and researchers used the better of the two times for their research. The research team used brain magnetic resonance imaging to evaluate cerebral small vessel disease.

Participants who were unable to balance on one leg for more than 20 seconds were at a higher risk for cerebral small vessel disease, most notably small infarctions — a type of ischemic stroke that occurs when blood supply to the brain is blocked or leaks outside vessel walls. These small infarctions did not show any symptoms, such as lacunar infarction and microbleeds. The presence of both lacunar infarction and microbleeds is usually associated with cognitive decline.

Findings revealed that 34.5 percent of participants with more than two lacunar infarction legions had trouble balancing on one leg, while 16 percent of those with one lacunar infarction lesions also struggled with balancing. Thirty percent of participants with more than one microbleed lesion had trouble balancing on one leg and 15.3 percent of those with one microbleed lesion had trouble balancing. On average, patients with cerebral disease were older and those who were unable to stand on one leg for over 20 seconds recorded lower cognitive scores.

"Our study found that the ability to balance on one leg is an important test for brain health," Tabara added. "Individuals showing poor balance on one leg should receive increased attention, as this may indicate an increased risk for brain disease and cognitive decline."

According to the American Stroke Association, small vessel disease is a condition in which already small arteries in the heart become even narrower. It is often a common occurrence of aging; however, factors such as high blood pressure and diabetes can worsen this condition. Patients with small vessel disease are at a higher risk for lacunar infarction and intracerebral hemorrhage.

Source: Okada Y, Ohara M, Tabara Y, et al. Stroke. 2014.