Falls are common (33% of those aged 65+ fall each year, 50% of those 80+) and are a very serious health risk for older people, being the major cause of accidental death in the elderly. They are not random events and although falls are typically multi-factorial and linked to a variety of intrinsic and extrinsic factors, studies indicate that visual impairment is a significant risk factor. Vision provides a significant input to balance control in addition to providing information about the size and position of hazards and obstacles in the travel pathway and allows us to negotiate steps and stairs.
Possible reasons why there has been so little improvement in falls rate in randomised controlled trials of correcting visual impairment by cataract surgery and updating glasses will be discussed, particularly the Cummings et al. (2007) optometric intervention study, which found an increased falls rate after updating spectacles. Guidance will be given on how the optometrist can play their part in preventing falls, particularly in relation to the type of spectacle lens and the refractive correction prescribed to elderly frail patients.
Three main topics of the lecture
- To understand the consequences of falls in older people.
- To understand the link between vision and falls in the elderly.
- To understand the role an optometrist can play in the multi-disciplinary care of older people at risk of falling.