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Vision Impairment and the Increased Risk of Recurrent Falls in the Elderly

Elio Arruzza

Falls are the second leading cause of accidental deaths worldwide mainly in older people. Older people have poor vision and published evidence suggests that it is a risk factor for falls. Less than half of falls clinics assess vision as part of the multi-factorial assessment of older adults at risk of falls despite vision being an essential input for postural stability. The aim of our study was to investigate the relationship between all clinically assessed visual functions and falls amongst older adults in a prospective observational individually age-matched case control study.

Visual acuity (VA), contrast sensitivity, depth perception, binocular vision and binocular visual field were measured using routinely used clinical methods in falls participants and non-falls participants. Data were also collected on socio-demographic factors, general health, and number of medications, health quality and fear of falling and physical activity. Logistic regression analysis was carried out to determine key visual and non-visual risk factors for falls whilst adjusting for confounding covariates. The results concerning the relationships between poor visual acuity and poor contrast sensitivity and the risk of recurrent falls are controversial. More studies about the relationships between different measures of vision and the risk of recurrent falls are needed before final conclusions about poor vision as a risk factor for recurrent falling can be done.