title: Poor vision accompanied with other sensory impairments as a predictor of falls in older women.
abstract: OBJECTIVE
  we studied visual acuity (VA) and co-existing hearing impairment and poor standing balance as predictors of falls.
  
  
  METHODS
  prospective study with 1-year follow-up.
  
  
  METHODS
  research laboratory and residential environment.
  
  
  METHODS
  428 women aged 63-76 years from the Finnish Twin Study on Aging.
  
  
  METHODS
  participants were followed up for incidence of falls over 1 year. VA, hearing ability and standing balance were assessed at the baseline. The incidence rate ratios (IRR) for falls were computed using the negative binomial regression model.
  
  
  RESULTS
  during the follow-up, 47% of participants experienced a fall. After adjusting for age and interdependence of twin sisters, participants with vision impairment (VA of <1.0) but no other sensory impairments had a higher, but non-significant, risk for falls compared to persons with normal vision (IRR 1.5, 95% CI 0.6-4.2). Co-existing vision impairment and impaired balance increased the risk (IRR 2.7, 95% CI 0.9-8.0), as also did co-existing vision and hearing impairment (IRR 4.2, 95% CI 1.5-11.3), compared to those with normal vision. Among persons with all three impairments, the IRR for falls increased to 29.4 (95% CI 5.8-148.3) compared to participants with good vision.
  
  
  CONCLUSIONS
  the impact of vision impairment on fall risk was higher when accompanied with other sensory and balance impairments, probably because the presence of other impairments prevented the reception of compensatory information about body posture and environment being received from other sensory sources. When aiming to prevent falls and their consequences in older people, it is important to check whether poor vision is accompanied with other impairments.
authors.affiliation: Department of Health Sciences, The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Finland. jenni.kulmala@sport.jyu.fi
authors.forename: Jenni
authors.initials: J
authors.lastname: Kulmala
authors.forename: Anne
authors.initials: A
authors.lastname: Viljanen
authors.forename: Sarianna
authors.initials: S
authors.lastname: Sipilä
authors.forename: Satu
authors.initials: S
authors.lastname: Pajala
authors.forename: Olavi
authors.initials: O
authors.lastname: Pärssinen
authors.forename: Markku
authors.initials: M
authors.lastname: Kauppinen
authors.forename: Markku
authors.initials: M
authors.lastname: Koskenvuo
authors.forename: Jaakko
authors.initials: J
authors.lastname: Kaprio
authors.forename: Taina
authors.initials: T
authors.lastname: Rantanen
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D034381:Hearing Loss / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D004856:Postural Balance; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D015354:Vision, Low / Q000453:epidemiology*; D014792:Visual Acuity