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

Overview

Journal J Am Geriatr Soc

Specialty Geriatrics

Date 2018 Nov 14

PMID 30421796

Citations 37

Authors

Joshua R Ehrlich

Shirin E Hassan

Brian C Stagg

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Trends in prevalence and disability-adjusted life years for refractive disorders in China and globally from 1990 to 2021: an analysis of the Global Burden of Disease Study 2021.

Lai F, Xia H, Wang L Front Public Health. 2025; 13:1517056.

PMID: 40013051 PMC: 11860090. DOI: 10.3389/fpubh.2025.1517056.

Prevalence of falls and associations with family functioning among community-dwelling older adults in Guangzhou, China.

Sun S, Wang Z, Peng Z, Yuan L, Yang W, Zhang W Front Public Health. 2024; 12:1450745.

PMID: 39726650 PMC: 11669552. DOI: 10.3389/fpubh.2024.1450745.

Effect of increased fear of falling on falls in patients undergoing HD: A narrative review.

Shirai N, Morishita S, Osawa Y, Yamamoto S Fukushima J Med Sci. 2024; 71(1):13-24.

PMID: 39662936 PMC: 11799665. DOI: 10.5387/fms.24-00014.

Most State Medicaid Programs Cover Routine Eye Exams For Adults, But Coverage Of Other Routine Vision Services Varies.

Lipton B, Garcia J, Boudreaux M, Azatyan P, McInerney M Health Aff (Millwood). 2024; 43(8):1073-1081.

PMID: 39102604 PMC: 11460127. DOI: 10.1377/hlthaff.2023.00873.

Meteorological parameters and hospital-acquired falls-A multicenter retrospective study based on 10 years of adverse events reporting system data.

Ren Y, Li J, Yang J, Hu L, Xu Z, Fu R Heliyon. 2024; 10(13):e34193.

PMID: 39071631 PMC: 11279767. DOI: 10.1016/j.heliyon.2024.e34193.

References

van Landingham S, Massof R, Chan E, Friedman D, Ramulu P . Fear of falling in age-related macular degeneration. BMC Ophthalmol. 2014; 14:10. PMC: 3922687. DOI: 10.1186/1471-2415-14-10. View

Crews J, Campbell V . Vision impairment and hearing loss among community-dwelling older Americans: implications for health and functioning. Am J Public Health. 2004; 94(5):823-9. PMC: 1448344. DOI: 10.2105/ajph.94.5.823. View

Chang V, Do M . Risk factors for falls among seniors: implications of gender. Am J Epidemiol. 2015; 181(7):521-31. DOI: 10.1093/aje/kwu268. View

Lord S, Dayhew J . Visual risk factors for falls in older people. J Am Geriatr Soc. 2001; 49(5):508-15. DOI: 10.1046/j.1532-5415.2001.49107.x. View

Hu J, Xia Q, Jiang Y, Zhou P, Li Y . Risk factors of indoor fall injuries in community-dwelling older women: a prospective cohort study. Arch Gerontol Geriatr. 2015; 60(2):259-64. DOI: 10.1016/j.archger.2014.12.006. View

Chan T, Friedman D, Bradley C, Massof R . Estimates of Incidence and Prevalence of Visual Impairment, Low Vision, and Blindness in the United States. JAMA Ophthalmol. 2017; 136(1):12-19. PMC: 5833607. DOI: 10.1001/jamaophthalmol.2017.4655. View

Scheffer A, Schuurmans M, van Dijk N, van der Hooft T, de Rooij S . Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008; 37(1):19-24. DOI: 10.1093/ageing/afm169. View

El-Gasim M, Munoz B, West S, Scott A . Associations between self-rated vision score, vision tests, and self-reported visual function in the Salisbury Eye Evaluation Study. Invest Ophthalmol Vis Sci. 2013; 54(9):6439-45. PMC: 4590654. DOI: 10.1167/iovs.12-11461. View

Paliwal Y, Slattum P, Ratliff S . Chronic Health Conditions as a Risk Factor for Falls among the Community-Dwelling US Older Adults: A Zero-Inflated Regression Modeling Approach. Biomed Res Int. 2017; 2017:5146378. PMC: 5387801. DOI: 10.1155/2017/5146378. View

10.

Grimbergen Y, Schrag A, Mazibrada G, Borm G, Bloem B . Impact of falls and fear of falling on health-related quality of life in patients with Parkinson's disease. J Parkinsons Dis. 2013; 3(3):409-13. DOI: 10.3233/JPD-120113. View

11.

Cho B, Seo D, Lin H, Lohrmann D, Chomistek A . BMI and Central Obesity With Falls Among Community-Dwelling Older Adults. Am J Prev Med. 2018; 54(4):e59-e66. DOI: 10.1016/j.amepre.2017.12.020. View

12.

Ramulu P, van Landingham S, Massof R, Chan E, Ferrucci L, Friedman D . Fear of falling and visual field loss from glaucoma. Ophthalmology. 2012; 119(7):1352-8. PMC: 3389306. DOI: 10.1016/j.ophtha.2012.01.037. View

13.

Donoghue O, Ryan H, Duggan E, Finucane C, Savva G, Cronin H . Relationship between fear of falling and mobility varies with visual function among older adults. Geriatr Gerontol Int. 2013; 14(4):827-36. DOI: 10.1111/ggi.12174. View

14.

Yip J, Khawaja A, Broadway D, Luben R, Hayat S, Dalzell N . Visual acuity, self-reported vision and falls in the EPIC-Norfolk Eye study. Br J Ophthalmol. 2013; 98(3):377-82. PMC: 3933174. DOI: 10.1136/bjophthalmol-2013-304179. View

15.

Rubenstein L, Josephson K . The epidemiology of falls and syncope. Clin Geriatr Med. 2002; 18(2):141-58. DOI: 10.1016/s0749-0690(02)00002-2. View

16.

Freeman E, Munoz B, Rubin G, West S . Visual field loss increases the risk of falls in older adults: the Salisbury eye evaluation. Invest Ophthalmol Vis Sci. 2007; 48(10):4445-50. DOI: 10.1167/iovs.07-0326. View

17.

Handrigan G, Maltais N, Gagne M, LaMontagne P, Hamel D, Teasdale N . Sex-specific association between obesity and self-reported falls and injuries among community-dwelling Canadians aged 65 years and older. Osteoporos Int. 2016; 28(2):483-494. DOI: 10.1007/s00198-016-3745-x. View

18.

Ivers R, Cumming R, Mitchell P, Attebo K . Visual impairment and falls in older adults: the Blue Mountains Eye Study. J Am Geriatr Soc. 1998; 46(1):58-64. DOI: 10.1111/j.1532-5415.1998.tb01014.x. View

19.

Lam B, Lee D, Zheng D, Davila E, Christ S, Arheart K . Disparity in prevalence of self-reported visual impairment in older adults among U.S. race-ethnic subgroups. Ophthalmic Epidemiol. 2009; 16(3):144-50. PMC: 4084731. DOI: 10.1080/09286580902863007. View

20.

White U, Black A, Wood J, Delbaere K . Fear of falling in vision impairment. Optom Vis Sci. 2015; 92(6):730-5. DOI: 10.1097/OPX.0000000000000596. View