Seresirikachorn Kasem, Somyanonthanakul Rachasak, Johnson Matthew, Singhanetr Panisa, Gatedee Jiraporn, Friedman David, Zebardast Nazlee
Massachusetts Eye and Ear Infirmary, Harvard Medical School, 243 Charles Street, Boston, MA, 02114, United States, 1 617-573-3202.
Department of Ophthalmology, College of Medicine, Rangsit University, Rajavithi Hospital, Bangkok, Thailand.
JMIR Aging. 2025 Jul 31;8:e68771. doi: 10.2196/68771.
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.
The objective of this study was to investigate the association between vision impairment and falls and assess whether subjective vision impairment predicts future falls in older adults.
This cross-sectional and longitudinal analysis used data from the HRS (1996-2020) to assess the relationship between self-reported vision, glaucoma history, and falls among US adults aged 65 years and older. HRS uses a biennial, multistage area probability sample survey design, collecting data with community-dwelling individuals followed up every 2 years until death, tracking health, economic, and social outcomes. Multivariate logistic regression was used to analyze associations between self-reported vision and self-reported falls in the past 2 years.
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 (adjusted odds ratio [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.
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.
跌倒是老年人受伤的主要原因，视力障碍被认为是一个重要的风险因素。然而，许多现有研究受到样本量小、回顾性设计或对混杂因素调整不足的限制。为了克服这些限制，我们使用了密歇根大学健康与退休研究（HRS）的数据，在一个具有全国代表性的大样本中分析老年人自我报告的视力与跌倒风险之间的关联。
本研究的目的是调查视力障碍与跌倒之间的关联，并评估主观视力障碍是否能预测老年人未来的跌倒情况。
这项横断面和纵向分析使用了HRS（1996 - 2020年）的数据，以评估65岁及以上美国成年人自我报告的视力、青光眼病史与跌倒之间的关系。HRS采用两年一次的多阶段区域概率抽样调查设计，收集社区居住个体的数据，每两年随访一次直至死亡，跟踪健康、经济和社会结果。多变量逻辑回归用于分析过去两年自我报告的视力与自我报告的跌倒之间的关联。
共有38,835名受访者提供了117,834份观察数据。报告跌倒的参与者加权比例为37.9%（95%可信区间37.7% - 40.1%）。跌倒的显著风险因素包括总体视力障碍（调整后的优势比[aOR] 1.36，95%可信区间1.20 - 1.56）、远视力障碍（aOR 1.37，95%可信区间1.32 - 1.42）、近视力障碍（aOR 1.33，95%可信区间1.27 - 1.37）和青光眼（aOR 1.15，95%可信区间1.07 - 1.24）。在严重跌倒方面也观察到类似的关联，其中总体视力障碍（aOR 1.20，95%可信区间1.03 - 1.44）；远视力障碍（aOR 1.14，95%可信区间1.07 - 1.22）、近视力障碍（aOR 1.12，95%可信区间1.05 - 1.18）和青光眼（aOR 1.15，95%可信区间1.05 - 1.26）具有显著性。在纵向分析中，总体视力障碍（aOR 1.23，95%可信区间1.16 - 1.29）、远视力障碍（aOR 1.27，95%可信区间1.20 - 1.38）、近视力障碍（aOR 1.23，95%可信区间1.19 - 1.32）和青光眼（aOR 1.25，95%可信区间1.13 - 1.37）增加了未来跌倒的风险。报告的总体视力在同一调查周期（P <.001）和后续调查周期（P <.001）与跌倒次数均显著相关。
远视力和近视力障碍以及青光眼都与老年人较高的跌倒风险相关，是可能进行干预和预防的领域。
