Correlates of recurrent falling in independent community-dwelling older adults.

This study compared the ability of selected measures of vision, health, physical activity and performance, and fall history to predict the risk of recurrent falls in independent community-dwelling older adults. Of particular interest was the association between visual field (VF) constriction and falling. Age-related VF constriction is well documented and is known to accelerate in persons over age 55. Although several authors have implied that VF constriction in older adults could contribute to instability and falls, there has been no attempt to systematically examine this relationship. A battery of tests were administered to men and women (N = 96) 60-88 years of age. Falls were closely monitored for 1 year following the testing. Fifty of the 96 participants (52%) fell during the 1-year monitoring period, amassing a total of 91 falls, 5 of which resulted in fractures. There were 46 nonfallers, 27 one-time fallers, and 23 recurrent fallers. A stepwise logistic regression analysis revealed that average VF constriction, use of eyeglasses, and low systolic blood pressure were independently associated with recurrent falling. On discriminant function analysis, these 3 variables predicted status as a recurrent faller correctly in 48% of cases, and predicted nonfaller status correctly in 93% of cases. The overall performance of the model was 70%. Hypotheses are offered for how average VF constriction, use of eyeglasses, and low systolic blood pressure could influence stability and fall risk in older adults.