Vision and falls: A multidisciplinary review of the contributions of visual impairment to falls among older adults

Reed-Jones, Rebecca J.; Solis, Guillermina; Lawson, Katherine; Loya, Amanda M.; Cude-Islas, Donna; Berger, Candyce S.

doi:10.1016/j.maturitas.2013.01.019

Cited by 141 publications

(86 citation statements)

References 54 publications

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“…Our study confirms the findings of prior investigations that have found a strong association between VI and falls . An investigation using nationally representative data from the Behavioral Risk Factor Surveillance System found a higher prevalence of falls (46.7%) than in the current study (27.6%) .…”

Section: Discussionsupporting

confidence: 91%

See 1 more Smart Citation

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Ehrlich

Hassan

Stagg

2018

J American Geriatrics Society

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Objectives To determine the prevalence of falls, fear of falling (FoF), and activity limitation due to FoF in a nationally representative study of older adults with self‐reported vision impairment (VI). Design Cross‐sectional analysis of panel survey data. Setting National Health and Aging Trends Study, a nationally representative survey administered annually from 2011 to 2016 to U.S. Medicare beneficiaries aged 65 and older. Participants Respondents (N=11,558) who contributed 36,229 participant observations. Measurements We performed logistic regression to calculate the unadjusted and adjusted prevalence of self‐reported history of more than 1 fall in the past year, any fall in the past month, FoF, and activity limitation due to FoF in participants with and without self‐reported VI. Results The weighted proportion of participants reporting VI was 8.6% (95% confidence interval (CI)=8.0–9.2%). The unadjusted prevalence of more than 1 fall in the past year was 27.6% (95% CI=25.5–29.7%) in participants with self‐reported VI and 13.2% (95% CI=12.7–13.7%) in those without self‐reported VI. In respondents with self‐reported VI, the prevalence of FoF was 48.3% (95% CI=46.1–50.6%) and of FoF limiting activity was 50.8% (95%CI 47.3–54.2%), and in those without self‐reported VI, the prevalence of FoF was 26.7% (95% CI=25.9–27.5%) and of FoF limiting activity was 33.9% (95% CI=32.4–35.4%). The prevalence of all fall and fall‐related outcomes remained significantly higher among those with self‐reported VI after adjusting for sociodemographics and potential confounders. Conclusion The prevalence of falls, FoF, and activity limitation due to FoF is high in older adults with self‐reported VI. This is the first study to provide nationally representative data on the prevalence of fall‐related outcomes in older Americans with self‐reported VI. These findings demonstrate the need to treat avoidable VI and to develop interventions to prevent falls and fall‐related outcomes in this population. J Am Geriatr Soc 67:239–245, 2019.

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Section: Discussionsupporting

confidence: 91%

“…Because of the aging of the population, the number of older adults with VI is predicted to increase through at least 2050 . VI is associated with lack of independence, poor subjective well‐being, and risk of falls . In a given year, approximately one‐third of adults aged 65 and older will fall and VI more than doubles this risk .…”

mentioning

confidence: 99%

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Ehrlich

Hassan

Stagg

2018

J American Geriatrics Society

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“…Finally, it has been suggested that some medications that can lead to ocular adverse events, e.g. antihistamines, antipsychotics, and tricyclic antidepressants, may contribute to falls by inducing changes in vision and vision loss[10]. Despite the evidences about the importance of visual assessment in patients who have fallen, and the strong attention for falls by the NHS in UK, a Royal College of Physicians audit in 2009 showed that most sites in UK did not employ a standardized visual acuity assessment.…”

Section: Introductionmentioning

confidence: 99%

Identifying fallers among ophthalmic patients using classification tree methodology

et al. 2017

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PurposeTo develop and validate a tool aiming to support ophthalmologists in identifying, during routine ophthalmologic visits, patients at higher risk of falling in the following year.MethodsA group of 141 subjects (age: 73.2 ± 11.4 years), recruited at our Eye Clinic, underwent a baseline ophthalmic examination and a standardized questionnaire, including lifestyles, general health, social engagement and eyesight problems. Moreover, visual disability was assessed by the Activity of Daily Vision Scale (ADVS). The subjects were followed up for 12 months in order to record prospective falls. A subject who reported at least one fall within one year from the baseline assessment was considered as faller, otherwise as non-faller. Different tree-based algorithms (i.e., C4.5, AdaBoost and Random Forests) were used to develop automatic classifiers and their performances were evaluated by the cross-validation approach.ResultsOver the follow-up, 25 falls were referred by 13 patients. The logistic regression analysis showed the following variables as significant predictors of prospective falls: pseudophakia and use of prescribed eyeglasses as protective factors, recent worsening of visual acuity as risk factor. Random Forest ranked best corrected visual acuity, number of sleeping hours and job type as the most important features. Finally, AdaBoost enabled the identification of subjects at higher risk of falling in the following 12 months with a sensitivity rate of 69.2% and a specificity rate of 76.6%.ConclusionsThe current study proposes a novel method, based on classification trees applied to self-reported factors and health information assessed by a standardized questionnaire during ophthalmological visits, to identify ophthalmic patients at higher risk of falling in the following 12 months. The findings of the current study pave the way to the validation of the proposed novel tool for fall risk screening on a larger cohort of patients with visual impairment referred to eye clinics.

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“…However, some major risk factors associated with falls, including physical fragility and cognitive issues, are not common in the young‐old age group. In contrast, depressive symptoms and visual impairment are prevalent in older people, even in the young‐old . Some of these cases could be preventable or remediable through early detection, but are often underdiagnosed in communities .…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, depression and visual impairment could be targets for fall prevention strategies in the young‐old age group. However, the participants of most previous studies investigating associations between depressive symptoms or visual impairment and falls have been in a broad older age group, with a mean age of 75 years or older . Indeed, few studies have investigated risk factors for falling among the young‐old age group.…”

Section: Introductionmentioning

confidence: 99%

Association between falls and depressive symptoms or visual impairment among Japanese young‐old adults

Kojima

Ukawa

Ando

et al. 2015

Geriatrics Gerontology Int

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Aim: To investigate the association between falls and self-reported depressive symptoms or visual impairment among young-old adults.Methods: A total of 1,904 participants (986 males and 918 females) aged 64 years from the New Integrated Suburban Seniority Investigation Project from 1996 to 2005, an age-specific cohort study in Nisshin, Japan. Depressive symptoms were evaluated using the Geriatric Depression Scale. Visual impairment was assessed using a self-administered questionnaire. The outcome variable was self-reported injurious falls at the age of 70. Multivariate odds ratios (ORs) and 95% confidence intervals (CIs) of depressive symptoms and visual impairment for the incidence of falls were calculated using logistic regression models and adjusted for possible confounding factors.Results: Overall, 77 (7.8%) males and 126 (13.7%) females reported falls within the last 1 year at age 70. Among females, depressive symptoms and visual impairment were significantly associated with falls after adjusting for potential confounders (OR: 1.70, 95% CI: 1.09-2.62; OR: 2.34, 95% CI: 1.45-3.71, respectively), but not among males.Female participants with both conditions had a significantly increased risk of falls after adjusting for potential confounders (OR: 3.50, 95% CI: 1.65-7.13) compared with those with neither condition; the association was not significant among males.Conclusions: Depressive symptoms and visual impairment at age 64 were significantly associated with an increased risk of falls at age 70 in Japanese females but not in males.The combination of the two symptoms had an even greater association with fall risk.

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Vision and falls: A multidisciplinary review of the contributions of visual impairment to falls among older adults

Cited by 141 publications

References 54 publications

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment

Identifying fallers among ophthalmic patients using classification tree methodology

Association between falls and depressive symptoms or visual impairment among Japanese young‐old adults

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