By Muhammad Shabbir
Publication Date: September 14, 2026
Getting older changes the body, but age alone does not tell the whole story about how well someone is aging.
A new study published in JAMA Network Open suggests that several measurable aspects of physical fitness may provide useful clues about health and longevity in adults 65 and older.
Researchers examined more than 13,000 older adults and assessed different aspects of physical capability, including cardiovascular fitness, muscular strength, flexibility, balance, and agility. They then compared performance with mortality outcomes over a median follow-up of seven years.
The strongest associations were seen with balance and agility, lower-body strength, and cardiorespiratory fitness.
That does not mean that passing a particular fitness test guarantees a longer life. The research was observational, so it cannot prove that improving one test score directly causes someone to live longer.
But it does highlight something important about healthy aging:
How well you can move, balance, stand, and sustain physical activity may tell us something about your overall physical reserve.
The 4 Areas of Fitness Researchers Examined
The study looked at four broad components of physical fitness:
Cardiorespiratory fitness
Muscular strength
Flexibility
Balance and agility
Participants completed seven standardized assessments covering these areas.
The tests included a two-minute step test, arm curls, chair stands, flexibility tests, a one-leg stance, and an eight-foot up-and-go test.
The researchers then linked the participants' fitness data with health insurance and mortality records.
1. Balance and Agility
Balance may become increasingly important as people get older because everyday life constantly requires the ability to control the body while standing and moving.
Walking around furniture, stepping off a curb, turning quickly, getting out of a chair, or recovering from a small loss of balance all require coordination.
In the study, the eight-foot up-and-go test and one-leg stance were among the fitness measures most strongly associated with lower all-cause mortality.
For the eight-foot up-and-go test, participants stood from a chair, walked eight feet around a marker, returned, and sat down.
The one-leg stance assessed how long participants could maintain their balance on one leg.
Compared with participants in the lowest performance groups, those in the highest performance groups had substantially lower mortality risk.
This is one reason balance should not be treated as an optional part of fitness.
It is a functional ability that combines strength, coordination, stability, and control.
For readers interested in measuring different aspects of physical capability, our guide to simple fitness tests after 40 provides additional examples of functional movements and what they can tell you.
2. Lower-Body Strength
Strong legs are useful for much more than exercise.
They help you stand up from a chair, climb stairs, walk, carry objects, get in and out of vehicles, and maintain your independence.
The study used the 30-second chair stand test to assess lower-body strength.
Participants repeatedly stood up from a chair and sat back down while keeping their arms crossed.
The researchers found that higher performance was associated with lower all-cause mortality.
Among the four individual tests with the lowest mortality risks, the chair stand test ranked behind the balance and agility measures but ahead of some other fitness assessments.
That finding makes practical sense.
A person's ability to repeatedly rise from a chair reflects more than isolated muscle strength. It also requires coordination, balance, mobility, and sufficient control of the lower body.
Why Lower-Body Strength Matters With Age
Maintaining leg strength can help preserve the physical abilities people rely on every day.
This doesn't mean older adults need to lift extremely heavy weights.
Strength training can be adapted to different abilities and may involve bodyweight exercises, resistance bands, machines, or free weights.
For more information, see our guide on what happens when you start strength training after 50.
3. Cardiorespiratory Fitness
The third major area was the ability to sustain physical activity using the heart and lungs.
Researchers assessed cardiorespiratory fitness with a two-minute step test, in which participants repeatedly lifted one leg at a time while standing.
Higher performance was associated with lower mortality risk.
The highest-performing group had a lower adjusted mortality risk than the lowest-performing group.
The association was not as strong as the composite fitness measure or the balance-and-agility tests, but cardiovascular fitness remained one of the important components linked with survival.
What Does Cardiorespiratory Fitness Mean?
Cardiorespiratory fitness describes the body's ability to deliver and use oxygen during physical activity.
You don't necessarily need to run long distances to work on it.
Depending on your abilities, activities such as brisk walking, cycling, swimming, dancing, or other sustained aerobic activities can contribute to cardiovascular fitness.
For adults 65 and older, U.S. physical activity guidance recommends aerobic activity along with muscle-strengthening and balance activities.
The CDC recommends at least 150 minutes of moderate-intensity aerobic activity per week for adults 65 and older who are able, along with muscle-strengthening activity on at least two days and activities that improve balance.
The amount and intensity should still be appropriate for an individual's abilities and health circumstances.
4. Flexibility
Flexibility was the fourth major area examined.
The researchers used two assessments:
A back-scratch test, which involved reaching the hands behind the back
A chair sit-and-reach test, which assessed lower-body flexibility
Flexibility was part of the overall fitness picture, although the strongest mortality associations in this study were seen with balance and agility, lower-body strength, and cardiorespiratory fitness.
That distinction matters.
The study did not show that every fitness quality was equally important or that flexibility alone determines longevity.
Instead, it suggests that physical fitness is multidimensional.
Someone can have good cardiovascular endurance but poor balance.
Another person might have strong legs but limited mobility.
Healthy aging therefore isn't about achieving one perfect fitness score.
It is about maintaining enough physical capacity across several areas to continue functioning independently.
What the Study Actually Found
The study included 13,423 adults aged 65 and older who completed standardized fitness assessments in Taiwan between 2015 and 2016.
The average participant was approximately 73 years old, and about 63% of the participants were women.
Researchers followed participants for a median of seven years.
During that period, 1,631 participants died.
When researchers compared people across fitness-performance groups, higher performance was consistently associated with lower all-cause mortality.
Some of the strongest associations were:
Eight-foot up-and-go: adjusted hazard ratio 0.41 for the highest versus lowest performance quintile
One-leg stance: adjusted hazard ratio 0.50
30-second chair stand: adjusted hazard ratio 0.55
Two-minute step test: adjusted hazard ratio 0.58
The composite fitness index showed an adjusted hazard ratio of 0.39 for the highest versus lowest performance groups.
These numbers describe statistical associations after adjustment for several factors. They should not be interpreted as a prediction that an individual with a certain fitness score has a specific probability of dying.
Why Balance and Agility May Be Especially Important
One interesting aspect of the study is that balance and agility showed particularly strong associations with mortality.
That may be partly because these abilities represent several physical systems working together.
To walk around an obstacle, stand up quickly, turn, and sit down safely, you need:
Leg strength
Coordination
Balance
Mobility
Reaction
Body control
Poor performance can therefore indicate reduced functional reserve.
Falls are also a major concern among older adults. The CDC identifies falls as the leading cause of injury among adults 65 and older.
That makes maintaining balance and physical function an important part of healthy aging.
However, the study itself did not prove that better balance prevents death.
It found an association between performance and mortality.
That distinction is essential.
Does This Mean These Tests Can Predict How Long You'll Live?
No.
A fitness test is not a crystal ball.
The researchers found that people with better fitness scores tended to have lower mortality risk, but this does not mean you can take one test and calculate your lifespan.
There are many factors that influence longevity, including genetics, medical conditions, socioeconomic circumstances, lifestyle, environment, healthcare access, and many other variables.
Fitness may be one piece of the larger picture.
It is also possible that underlying health conditions contributed to both poorer fitness and higher mortality risk.
Because this was an observational cohort study, researchers could identify associations but could not establish that improving a specific test result would necessarily reduce someone's risk of death.
What This Means for Someone Over 65
The biggest takeaway isn't that everyone over 65 needs to start performing these exact tests.
Instead, the study reinforces the importance of maintaining functional fitness.
Think about what your body needs to do every day.
Can you get up from a chair without struggling?
Can you walk at a comfortable pace without becoming unusually exhausted?
Can you climb stairs?
Can you carry groceries?
Can you turn and change direction safely?
Can you maintain your balance when standing or walking?
These abilities can matter far more to daily independence than a number on a gym machine.
A Better Way to Think About Fitness After 65
Instead of focusing entirely on appearance or body weight, consider building a broader fitness base.
Build strength
Resistance exercise can help you maintain muscular strength and physical function.
Maintain cardiovascular fitness
Walking, cycling, swimming, dancing, and other aerobic activities can help maintain cardiorespiratory fitness.
Practice balance
Balance exercises can challenge your stability and coordination.
Maintain mobility
Gentle mobility and flexibility work can help you maintain the range of motion needed for everyday activities.
The CDC recommends that adults 65 and older combine aerobic activity, muscle-strengthening activity, and balance activities as part of their weekly routine.
If you're interested in practical resistance exercises, you can also explore our guide to building strength after 50 with dumbbell exercises.
You Don't Need to Be an Athlete
One of the most useful lessons from this research is that healthy aging isn't necessarily about athletic performance.
You don't need to run marathons.
You don't need to lift enormous weights.
You don't need to compete with people half your age.
The goal is to preserve enough strength, balance, endurance, and mobility to keep participating in the activities that matter to you.
For one person, that might mean walking with friends.
For another, it might mean playing with grandchildren, gardening, traveling, climbing stairs, or carrying groceries without assistance.
Fitness has value because it supports the life you want to continue living.
Should You Try These Fitness Tests at Home?
Not necessarily.
The tests used in the study were standardized assessments conducted in a research setting.
Trying to reproduce them at home does not turn them into medical screening tools.
If you are healthy, steady on your feet, and familiar with exercise, simple functional movements may provide a useful personal benchmark.
But people with a history of falls, significant balance problems, pain, recent injury, or medical conditions should be cautious about performing unsupported or timed challenges.
There is no benefit to risking a fall just to obtain a fitness score.
If you're unsure whether a particular exercise or test is appropriate, ask a qualified healthcare professional or exercise professional for individualized guidance.
What the Study Cannot Tell Us
Several limitations are important.
First, this was an observational cohort study. Researchers observed relationships between fitness and mortality rather than assigning participants to exercise programs.
Second, the fitness assessments were performed at a single point in time. The study therefore could not fully determine how changes in fitness over the years affected mortality.
Third, the study population consisted of older adults in Taiwan who met specific eligibility criteria. The findings may not apply identically to every older adult population.
Finally, even though the researchers adjusted for several demographic, lifestyle, and health-related factors, observational research can still be affected by confounding.
So the findings are valuable evidence about the relationship between physical fitness and mortality, but they are not proof that increasing one particular fitness score will extend someone's life.
The Bottom Line
New research involving more than 13,000 adults aged 65 and older found that better performance across several areas of physical fitness was associated with lower all-cause mortality.
The strongest individual associations involved balance and agility, lower-body strength, and cardiorespiratory fitness.
Flexibility was also included in the researchers' broader assessment of physical fitness.
The message isn't that one fitness test determines your future.
It's that physical capability appears to be an important part of healthy aging.
Maintaining strong legs, steady balance, cardiovascular fitness, and useful mobility may help you preserve the independence needed for everyday life.
And you don't have to become an athlete to work on those abilities.
Start where you are, progress gradually, and focus on staying capable—not on chasing a perfect score.
Medical Disclaimer
This article is for general educational purposes only and does not provide individualized medical advice. Fitness tests and exercise recommendations may not be appropriate for everyone. If you have a medical condition, significant pain, a history of falls, balance problems, or concerns about starting or changing an exercise routine, speak with a qualified healthcare professional before proceeding.
Sources
Wu M, Hsu C, Hsu H, et al. Physical Fitness and All-Cause Mortality in Older Adults. JAMA Network Open. 2026;9(8):e2628227.
Centers for Disease Control and Prevention. Older Adult Activity: An Overview.
Centers for Disease Control and Prevention. Older Adult Falls Data.
U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Physical Activity Guidelines.
Suggested Internal Links
1. 5 Fitness Tests That Reveal How Fit You Really Are After 40
Best placed in the section discussing functional testing and personal fitness benchmarks.
2. What Happens When You Start Strength Training After 50? The Benefits, Risks, and What to Know
Best placed in the lower-body strength / practical exercise section.
3. Build Strength After 50 With 11 Dumbbell Exercises
Best placed when discussing practical ways to maintain muscular strength.
4. How Daily Movement Can Support Healthy Aging After 40
Optional fourth link for the broader healthy-aging and physical-activity discussion.
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