Visual impairment and falls in older adults: the Blue Mountains Eye Study.
OBJECTIVE
To examine the association between visual impairment and falls in older people.


METHODS
Cross-sectional survey of eye disease with retrospective collection of falls data.


METHODS
Two postcode areas in the Blue Mountains west of Sydney, Australia.


METHODS
All people 49 years of age and older were invited to participate, 3654 (82.4%) of 4433 eligible residents took part, and 3299 answered questions about falls.


METHODS
Subjects had a detailed eye examination and answered questions about health and vision status, use of medication, and number of falls in the previous 12 months.


RESULTS
Tests of visual function that had a statistically significant association with two or more falls after adjustment for confounders were visual acuity (prevalence ratio (PR) 1.9 for visual acuity worse than 20/30), contrast sensitivity (PR 1.2 for a 1-unit decrease at 6 cycles per degree), and suprathreshold visual field screening (PR 1.5 for 5 or more points missing). However, only visual acuity and contrast sensitivity were significantly associated with two or more falls per 1 standard deviation decrease. The presence of posterior subcapsular cataract (PR 2.1) and use of nonmiotic glaucoma medication (PR 2.0) had a statistically significant association with two or more falls; presence of age-related macular degeneration, diabetic retinopathy, and cortical or nuclear cataract did not.


CONCLUSIONS
Visual impairment is strongly associated with two or more falls in older adults. In addition to poor visual acuity, visual factors such as reduced visual field, impaired contrast sensitivity, and the presence of cataract may explain this association.
Ivers
R Q
RQ
Department of Public Health and Community Medicine, University of Sydney, New South Wales, Australia.
Cumming
R G
RG
Mitchell
P
P
Attebo
K
K
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000150:complications; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D016012:Poisson Distribution; D016016:Proportional Hazards Models; D014786:Vision Disorders / Q000150:complications* / Q000175:diagnosis; D014792:Visual Acuity