Falls and vision impairment: guidance for the optometrist

Looking at the link between poor vision and falls, and possible interventions.

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Introduction

Several studies have indicated that approximately a third of community-dwelling, healthy adults aged 65 years and over fall at least once a year, with up to half of these people experiencing multiple falls (reviewed in Black and Wood 2005; College of Optometrists 2011; Lord et al. 2007). Annual fall rates increase to about 60% in people aged 90 years and over (Fleming et al. 2008). With the increasing size of the older population, particularly among the oldest old most at risk of falling, the number of people falling will also increase. For example, the UK population over 65 years is predicted to increase from 10.5 million in 2011 (16.8% of the population: 1 in 6 people) to 15.8 million (22.3%: 1 in 4.5 people) in 2031 and the population aged 75 will increase even more over that time period from about 5 million (8%: 1 in 12 people) to 8.3 million (11.7%: 1 in 9 people) (Office for National Statistics 2011). Also note that falls rate data are often from retrospectively questioning older people about falls in the previous year, so are likely underestimates due to poor memory recall (Cummings et al. 1998). Falls are more common in care homes, where up to 60% of residents fall at least once a year (Rubinstein et al. 1994). This is partly due to care-home residents often being more frail and having more of the other risk factors related to falls and partly due to the better reporting of falls in care homes. 

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