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The following is a summary of “Falls and Multiple Falls among United States Older Adults with Vision Impairment,” published in the November 2024 issue of Ophthalmology by Thomas et al. 

Researchers conducted a retrospective study investigating the cross-sectional and longitudinal associations in older adults (OAs) between visual impairment (VI) and falls in the United States. 

They analyzed VI and falls in Medicare beneficiaries aged ≥71 years, focusing on 2,822 community-dwelling OAs with complete vision and falls data from 2021. The longitudinal analysis involved 2,367 participants with complete follow-up data on vision and falls, VI was defined as distance VI [>0.3 logMAR], near VI [>0.3 logMAR], or contrast sensitivity (CS) impairment [<1.55 logCS]. Changes in distance visual acuity (DVA) [logMAR/year], near visual acuity (NVA) [logMAR/year], and CS (logCS/year) were also assessed. Falls were self-reported within the past 12 months, with those reporting more than 1 fall categorized as having multiple falls.  

The results showed that among 2,822 participants, the mean age was 78.5 (SD=5.6) years, with 54.7% female and 81.7% non-Hispanic White while, 35.4% reported a fall in the past 12 months, and 44.6% had multiple falls. At baseline, individuals with any VI had higher rates of falls (rate ratio = 1.16, 95% CI=1.04–1.30) and multiple falls (rate ratio = 1.23, 95% CI=1.01–1.49) compared to those without VI. Longitudinal analysis showed no increased risk of falls or multiple falls in individuals with VI at baseline. However, worse CS (hazard ratio [HR]=1.03, 95% CI=1.01–1.06, per 0.1 logCS worse) and DVA (HR=1.11, 95% CI=1.04–1.18, per 0.1 logMAR worse) were linked to higher fall risks.The Change in NVA (HR=1.04, 95% CI=1.01–1.08, per 0.1 logMAR worse/year) was associated with increased fall risk, while worsening CS (HR=1.11, 95% CI=1.05–1.18, per 0.1 logCS worse/year) increased the risk of multiple falls and  changes in DVA and NVA were not associated with various falls.  

Investigators concluded the OAs with VI had an increased risk of falls, and specific VI contributing to the risk. 

Source: ajo.com/article/S0002-9394(24)00543-9/abstract