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

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.

Keywords: NHATS; aging; epidemiology; falls; fear of falling; ophthalmology; survey; vision.