Visual Field Loss Increases the Risk of Falls in Older Adults: The Salisbury Eye Evaluation

PURPOSE: Falls are a serious and preventable problem in older adults. Impaired vision has been linked to risk of falls; however, the impact of deficits in specific components of vision on the risk of falls is not well known. METHODS: Data on falls for up to 20 months were provided by 2375 individuals participating in the Salisbury Eye Evaluation (SEE). Visual acuity, contrast sensitivity, visual field, and stereoacuity were tested by using standard measures. To aid in the assessment, each participant recorded falls on a calendar that was sent every month to the SEE clinic. beta-Binomial regression analysis was used. RESULTS: Worse visual field scores were associated with the risk of falling (OR = 1.08 for a 10-point loss of points, 95% CI 1.03-1.13). When both central (</= 20 degrees radius) and peripheral visual fields were in the same model, only the peripheral visual field was associated with falls (OR = 1.06, 95% CI 1.01-1.10). Visual acuity, contrast sensitivity, and stereoacuity were not associated with falls after adjustment for demographic and health variables. CONCLUSIONS: Visual field loss is the primary vision component that increases the risk of falls. This finding highlights the importance of visual field deficits in the risk of falls and supports other findings on decrements in mobility and increased risk of bumping with worsening visual field function. Persons with visual field loss may benefit from mobility training to reduce the risk of falling.