Visual impairment and falls in the elderly: The Shihpai eye study

Background: To investigate the association between visual impairment and falls in a metropolitan elderly Chinese population. Methods: A population-based cross-sectional study of eye diseases among subjects 65 years of age and older was conducted in the Shihpai community of Taipei between July 1, 1999 and December 31, 2000. Results: Of the 2,045 subjects invited, 1,361 (66.6%) participated in both the questionnaire and the eye examination. Sixty-two (4.6%; 95% confidence interval [CI], 3.4-5.7%) had experienced 2 or more falls in the previous 12 months. On univariate analysis, best-corrected Snellen visual acuity of the better eye less than 6/12 (odds ratio [OR], 2.47; 95% CI, 1.18-5.18; p<0.001), female gender (OR, 2.52; 95% CI, 1.49-4.26; p<0.001), high waist-to-hip ratio (OR, 1.86; 95% CI, 1.00-3.47; p=0.01), history of diabetes mellitus (OR, 3.88; 95% CI, 2.27-6.62; p<0.001) and cardiovascular disease (OR, 2.26; 95% CI, 1.34-3.80; p=0.04) were significantly related to falls. In the final multiple logistic regression model controlling for other covariates, visual impairment (OR, 1.98; 95% CI, 1.02-4.32; p<0.001), female gender (OR, 2.34; 95% CI, 1.29-4.23; p<0.01), history of diabetes (OR, 3.61; 95% CI, 2.03-6.40; p<0.01) and cardiovascular disease (OR, 1.96; 95% CI, 1.13-3.40; p=0.04) were significantly related to falls. Conclusion: Falls were significantly associated with a best-corrected Snellen visual acuity of less than 6/12.