Having Poor Vision Can Raise Risk for Falls Among Older Adults

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Journal of the American Geriatrics Society Research Summary

Vision impairment and blindness affect one in 11 Americans age 65 and older. Because our population is aging, the number of older adults with vision problems is predicted to rise. Older adults who have impaired vision may be at risk for decreased independence, poorer well-being, and an increased risk of falls. For example, in any given year, approximately 30 percent of adults over age 65 will fall. Having impaired vision more than doubles this risk.

For older adults, falls are a major cause of illness and death. Even having a fear of falling is a challenge that can limit activity and worsen quality of life and independence as you age.

However, we don’t have much information on how often visually impaired older adults experience a fall, and we have even less information about what happens to them after a fall. A team of researchers suggested that we need this information in order to understand the scope of the problem and create ways to prevent falls in visually impaired older adults.

To learn more, the research team examined information from the National Health and Aging Trends Study (NHATS). They published their study in the Journal of the American Geriatrics Society.

Their goal was to provide up-to-date information on the frequency of falls. The team also wanted to learn more about the fear of falling and how it might limit activity among older adults who have vision impairments.

Participants in the study were considered visually impaired if they had trouble recognizing someone across the street and/or reading newspaper print, even when using corrective lenses.

Falls were defined as “any fall, slip, or trip” that involved losing balance and landing on the floor or ground or at a lower level. Participants were asked if they had any fall in the past month and if they fell more than once in the past 12 months. Fear of falling was determined by asking participants if they had worried about falling down in the last month. An additional question asked whether worrying about falling ever caused participants to limit their activities.

The researchers also asked about the number of chronic conditions the participants had, including heart attack, heart disease, high blood pressure, arthritis, osteoporosis, diabetes, lung disease, stroke, and cancer.

The researchers concluded that falls, fear of falling, and limiting activity were considerably more common among older adults who were visually impaired.

About 50 percent of people who said they had trouble seeing were afraid of falling and as a result, limited their activity. More than one in four older adults with vision problems had recurrent falls in the year before they were surveyed.

The researchers said their study suggested that taking steps to prevent falls for older adults with vision problems was important and could limit the harmful consequences of falls for older adults. What’s more, helping older adults prevent falls might also slow declines in well-being, quality of life, and independence associated with a fear of falling.

The researchers noted that vision impairment can be treated or even avoided in many cases, and they speculated that doing so might be a strategy to decrease falls and fall-related problems for some older adults with vision problems.

“We need more information about falls and the fear of falling in older adults with vision problems. This will help us design public health and clinical interventions to address some of the key consequences of vision loss for older adults,” said study co-author Joshua R. Ehrlich, MD, MPH.

This summary is from “Prevalence of Falls and Fall-Related Outcomes in Older Adults with Self-Reported Vision Impairment.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Joshua R. Ehrlich, MD, MPH; Shirin E. Hassan, BAppSc (Optom), PhD; and Brian C. Stagg, MD, MS.