title: Lowered vision as a risk factor for injurious accidents in older people.
abstract: OBJECTIVE
  Poor vision in older people is often related to increased fall risk. However, the association of the severity between visual deficit and risk for all kind of injurious accidents has not been widely studied. The aim of this study was to examine whether visual loss is associated with higher incidence of injurious accidents and whether walking speed or physical activity play a mediating role in the association.
  
  
  METHODS
  416 persons aged 75 and 80 years at baseline underwent visual acuity measurements. Visual acuity (VA) <0.3 in the better eye, with spectacle correction when necessary, was defined as visual impairment, VA >or=0.3 but <or=0.5 as lowered vision, and VA>0.5 as normal VA. Hospital records of accidents resulting in injury were monitored for 10 years after baseline.
  
  
  RESULTS
  During the 10-year follow-up, 239 (58%) participants suffered at least one injurious accident. The risk for injurious accidents in a multivariate model adjusted for age, gender, eye-related diseases, diabetes and cardiovascular diseases among participants with lowered vision was 1.45 (95% CI 1.08- 1.94), compared with that for people with normal visual acuity. Participants with visual impairment did not have an increased risk for injurious accidents (HR 1.20, 95% CI 0.82-1.75). Furthermore, neither walking speed nor physical activity had a mediating effect on the relationship between visual loss and accidents.
  
  
  CONCLUSIONS
  Lowered vision is a risk factor for injurious accidents in older people independent of mobility and physical activity. Interestingly, more severe visual impairment did not increase the risk. Early intervention strategies, for example, proper correction of refractive errors or cataract extraction, may potentially prevent injurious accidents in older people.
authors.affiliation: Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland. jenni.kulmala@sport.jyu.fi
authors.forename: Jenni
authors.initials: J
authors.lastname: Kulmala
authors.forename: Pertti
authors.initials: P
authors.lastname: Era
authors.forename: Olavi
authors.initials: O
authors.lastname: Pärssinen
authors.forename: Ritva
authors.initials: R
authors.lastname: Sakari
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
authors.forename: Eino
authors.initials: E
authors.lastname: Heikkinen
mesh_terms: D000058:Accidental Falls; D000059:Accidents; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009043:Motor Activity / Q000502:physiology; D015999:Multivariate Analysis; D011446:Prospective Studies; D012307:Risk Factors; D015354:Vision, Low / Q000150:complications*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities; D016138:Walking / Q000502:physiology