Higher risk of multiple falls among elderly women who lose visual acuity.
OBJECTIVE
To determine the association between changes in visual acuity (VA) and frequent falls in older women.


METHODS
Prospective cohort study.


METHODS
Two thousand two elderly community-residing women participating in the Study of Osteoporotic Fractures with measurements of VA at baseline and a follow-up examination 4 to 6 years later (mean of 5.6 years).


METHODS
Binocular VA with habitual correction was measured under standard illumination using Bailey-Lovie charts at baseline and fourth examinations. Change in VA was stratified into 5 categories: no change or VA gain, loss of 1 to 5 letters, loss of 6 to 10 letters, loss of 11 to 15 letters, and loss of >15 letters. A separate analysis considered decline in VA as the loss of >or=10 letters (>or=2 lines) on the Bailey-Lovie acuity measure between baseline and follow-up examinations.


METHODS
Data on falls were obtained from postcards sent every 4 months after the follow-up examination. Frequent falling was defined as >or=2 falls during a 1-year period after the follow-up examination.


RESULTS
Compared with women with stable or improved VA, women with declining acuity had significantly greater odds of experiencing frequent falling during the subsequent year. Odds ratios after adjustment for baseline acuity and other confounders were 2.08 (95% confidence interval [CI]: 1.39-3.12) for loss of 1 to 5 letters, 1.85 (95% CI: 1.16-2.95) for loss of 6 to 10 letters, 2.51 (95% CI: 1.39-4.52) for loss of 11 to 15 letters, and 2.08 (95% CI: 1.01-4.30) for loss of >15 letters. In the analysis of visual decline defined as a loss of >or=10 letters, heightened risk of frequent falling was evident in each of 2 subgroups defined by splitting the sample on baseline VA, with borderline significant evidence of a more pronounced effect in those women with baseline VA of 20/40 or worse (P value for interaction, 0.083).


CONCLUSIONS
Loss of vision among elderly women increases the risk of frequent falls. Prevention or correction of visual loss may help reduce the number of future falls.
Coleman
Anne L
AL
Jules Stein Eye Institute and the UCLA Department of Ophthalmology, UCLA School of Medicine, Los Angeles, California 90095-7004, USA.
Stone
Katie
K
Ewing
Susan K
SK
Nevitt
Michael
M
Cummings
Steven
S
Cauley
Jane A
JA
Ensrud
Kristine E
KE
Harris
Emily L
EL
Hochberg
Marc C
MC
Mangione
Carol M
CM
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology; D016330:Frail Elderly / Q000706:statistics & numerical data*; D006305:Health Status Indicators; D006801:Humans; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000150:complications* / Q000517:prevention & control; D014792:Visual Acuity; D016387:Women's Health