Improving vision to prevent falls

Poor vision is a very strong risk factor for falls and fractures. The Blue Mountains Eye Study (link here) has confirmed that visual impairment is strongly associated with an increased risk of falls and hip fracture. Poor visual acuity, posterior subcapsular cataract or a visual field deficit are all associated with increased risk of both falls and hip fracture.

Randomized trial

Ensuring that older people have access to regular eye examinations and have timely treatment for eye diseases, such as cataract, may substantially reduce the incidence of falls and subsequent hip fracture in the community. To this test the effect of vision-related interventions to prevent falls, a randomized trial of nearly 800 people aged 70 years was conducted during 2002 and 2003. Subjects in the intervention group received detailed vision and eye examinations, with appropriate treatment provided for those found to have eye problems. Subjects in the intervention group received detailed vision and eye examinations, with appropriate treatment provided for those found to have eye problems.

To view the abstract of this study, Improving vision to prevent falls in frail older people: a randomized trial. Cumming RG, Ivers R, Clemson L, Cullen J, Hayes MF, Tanzer M, Mitchell P. J Am Geriatr Soc. 2007 Feb;55(2):175-81, link here .

Other Studies

In other studies where community-based intervention targeting older people living independently has been conducted, multiple risk factors of unsafe footwear, poor vision, inappropriate medication, balance or gait, insufficient exercise and environmental hazards have been identified. While acknowledging the limitations of the studies, they have shown indications that subjects adopting a preventive attitude and increased participation in falls prevention activities can in fact reduce the incidence of falls.

Publication details of related studies and information that deal with improving vision to prevent falls (and other aspects of fall prevention) follow:

• Poor vision and the risk of falls and fractures in older Australians: The Blue Mountains Eye Study Rebecca Ivers, Robert Cumming, Paul Mitchell. NSW Public Health Bulletin Vol. 13 No. 1-2.
  To view the pdf file of this paper, link here


• See also, the Blue Mountains Eye Study, link here


• Prevent Injuries from falls in older people - Background information to assist in the planning and evaluation of local Area-based strategies in New South Wales. NSW Health Department 2001
  To view the pdf file of this booklet , link here


• Home visits by an occupational therapist for assessment and modification of environmental hazards: a randomized trial of falls prevention. Cumming RG, Thomas M, Szonyi G, Salkeld G, O'Neill E, Westbury C, Frampton G. J Am Geriatr Soc. 1999 Dec;47(12):1471-2.
  To view the abstract for this paper, link here