Visual risk factors for falls in older adults: a case-control study

Mehta, J., Czanner, G., Harding, S., Newsham, D. and Robinson, J. (2022) Visual risk factors for falls in older adults: a case-control study. BMC Geriatrics, 22(1), p. 134. (doi: 10.1186/s12877-022-02784-3) (PMID:35177024) (PMCID:PMC8855581)

Abstract

Background: 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. Methods: Visual acuity (VA), contrast sensitivity (CS), depth perception, binocular vision and binocular visual field were measured using routinely used clinical methods in falls participants (N = 83) and non-falls participants (N = 83). Data were also collected on socio-demographic factors, general health, number of medications, health quality, 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. Results: Older adults have an increased risk of experiencing a fall if they have reduced visual function (odds ratio (OR): 3.49, 1.64-7.45, p = 0.001), specifically impaired stereoacuity worse than 85” of arc (OR: 3.4, 1.20-9.69, p = 0.02) and reduced (by 0.15 log unit) high spatial frequency CS (18 cpd) (OR:1.40, 1.12-1.80, p = 0.003). Older adults with a hearing impairment are also at higher risk of falls (OR: 3.18, 95% CI: 1.36-7.40, p = 0.007). The risk decreases with living in a less deprived area (OR: 0.74, 0.64-0.86, <0.001), or socialising more out of the home (OR: 0.75, 0.60-0.93, p = 0.01). Conclusions: The combination of social, behavioural and biological determinants are significant predictors of a fall. The non-visual risk factors include older adults, living in deprived neighbourhoods, socialising less outside of the home and those who have a hearing impairment. Impaired functional visual measures; depth perception and contrast are significant visual risk factors for falls above visual acuity.

• Item Type: Articles
• Additional Information: This work was funded by The Dunhill Medical Trust [RTF63/0116]. The funding body were responsible for funding the principle investigator (JM) for this study.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Robinson, Professor Jude
• Authors: Mehta, J., Czanner, G., Harding, S., Newsham, D., and Robinson, J.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: BMC Geriatrics
• Publisher: BioMed Central
• ISSN: 1471-2318
• ISSN (Online): 1471-2318
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in BMC Geriatrics 22(1):134
• Publisher Policy: Reproduced under a Creative Commons License