Abstract:

Explores the association between visual problems and falls among older adults, with a focus on the United Kingdom. Vision is 1 of 4 sensory mechanisms that detect perturbations of balance. Poor visual acuity approximately doubles the risk of falls. The association is demonstrated in studies of different designs, in community, institutional, and previous-faller populations, and with various outcomes. Adjustment for other fall risk factors generally has only a small effect, suggesting that the relationship between vision and falls is not explained or confounded by a third factor. Vision accounts for perhaps one-quarter to one-half of all falls, although this estimate is imprecise. Visual impairment in 70% or more of older adults is remediable with relatively simple interventions, such as correcting refracture errors and cataract surgery, making it an important potential target for intervention at the population level. However, no intervention has yet been proven to reduce fall risk in a randomized controlled trial.