JMIR Publications

ABSTRACT

Background:

Falls are the leading cause of injury among older adults, with vision impairment recognized as a significant risk factor. However, many existing studies have been limited by small sample sizes, retrospective designs, or insufficient adjustment for confounding factors. To overcome these limitations, we used data from the University of Michigan's Health and Retirement Study (HRS) to analyze the association between self-reported vision and fall risk among older adults in a large, nationally representative sample.

Objective:

To investigate the association between vision impairment and falls and assess if subjective vision impairment predicts future falls in older adults.

Methods:

This cross-sectional and longitudinal analysis used data from the Health and Retirement Study (1996-2020) to assess the relationship between self-reported vision, glaucoma history, and falls among U.S. adults aged 65 and older. Multivariate logistic regression was used to analyze associations between self-reported vision and self-reported falls in the past 2 years.

Results:

A total of 38,835 respondents contributed 117,834 observations. The weighted proportion of participants reporting falls was 37.9% (95% CI 37.7-40.1). Significant risk factors for falls included overall eyesight impairment (aOR 1.36, 95% CI 1.20-1.56), distance vision impairment (aOR 1.37, 95% CI 1.32-1.42), near vision impairment (aOR 1.33, 95% CI 1.27-1.37), and glaucoma (aOR 1.15, 95% CI 1.07-1.24). A similar association was observed for serious falls, where overall eyesight impairment (aOR 1.20, 95% CI 1.03–1.44), distance vision impairment (aOR 1.14, 95% CI 1.07–1.22), near vision impairment (aOR 1.12, 95% CI 1.05–1.18), and glaucoma (aOR 1.15, 95% CI 1.05–1.26) were significant. In longitudinal analyses, overall vision impairment (aOR 1.23, 95% CI 1.16-1.29), distance vision impairment (aOR 1.27, 95% CI 1.20-1.38), near vision impairment (aOR 1.23, 95% CI 1.19-1.32), and glaucoma (aOR 1.25, 95% CI 1.13-1.37) increased the risk of future falls. Reported overall vision was significantly associated with the number of falls in both the same (P<.001) and subsequent (P<.001) survey cycles.

Conclusions:

Both distance and near vision impairment as well as glaucoma are associated with a higher risk of falls in older adults and present possible areas for intervention and prevention.