Background/Objectives: One-leg standing test with eyes open (OLST), a well-known balance assessment, is simple to implement and requires no special measuring equipment or space. Prefrailty has greater reversibility than frailty, and early detection of prefrailty is essential for frailty prevention in older adults, especially women. However, the association between the OLST and prefrailty remains unclear. Therefore, this study aimed to verify the relationship between the OLST and prefrailty and to validate the effectiveness of the OLST as a screening tool for prefrailty in older Japanese women. Methods: This study included 208 community-dwelling older women (mean age: 74.4 ± 5.1 years; range: 65-89) who underwent frailty assessments and OLST. Prefrailty was assessed using the Japanese version of the Cardiovascular Health Study (J-CHS) criteria. The association between prefrailty and OLST was assessed by binary logistic regression analysis, and receiver operating characteristic analyses were performed to examine the effectiveness of OLST as a screening tool for prefrailty. Results: OLST time was significantly associated with prefrailty, and those with higher OLST times were less likely to have prefrailty (ORs: 0.98; 95% CI: 0.97-0.99; p < 0.001). The area under the curve of the OLST for prefrailty was 0.713 (p < 0.001), and the optimal OLST cut-off time for discriminating prefrailty was 24 s (sensitivity: 0.56, specificity: 0.77). Conclusions: OLST could be used as a screening tool for prefrailty in older Japanese women. These findings may contribute to the early detection and prevention of frailty.
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