Vision correction may raise fall risk in elderly

NEW YORK (Reuters Health) - Helping frail older people to see more clearly may put them at increased risk of falls, according to a new study from Australia.

This could be because getting used to a new eyeglass prescription may throw people off balance, Dr. Robert G. Cumming, at Concord Hospital in New South Wales, and colleagues suggest. Whatever the explanation, they say the findings indicate that programs aimed at preventing falls among the elderly by improving their vision should be put on hold for now.

One previous study found that removing cataracts -- which allows people to see contrasts more clearly -- reduced falls among elderly people, but another found no effect, Cumming and his team note in the Journal of the American Geriatrics Society.

To better understand how improving elderly people's vision might affect fall risk, the researchers randomly assigned 616 men and women aged 70 and older to receive vision and eye exams, along with appropriate treatment, or to receive their usual care.

In the treatment group, 92 people got new eyeglasses, 24 had a home visit with an occupational therapist, 17 received glaucoma treatment, and 15 had cataract surgery.

However, during the following year, 65 percent of people in the treatment group fell at least once, compared to 50 percent of those in the control group. Thirty-one fractures occurred in the treatment group, while there were 18 among the untreated participants.

Overall, the men and women given vision treatment were 57 percent more likely to fall and 74 percent more likely to sustain fractures than those in the control group.

One explanation for the findings is that study participants needed a long time to adjust to new eyeglasses, Cumming and his team said. It's also possible, they add, that people in the treatment group who were given a clean bill of visual health became more active and took "unaccustomed risks."

While the findings must be confirmed by other researchers, Cumming and his team add, "it may be premature to implement the wide range of vision-related interventions to prevent falls proposed by others."

They also advise that eye care providers working with elderly people should be aware that their patients may be more prone to fall after receiving a new set of glasses. "They should prescribe conservatively and give appropriate advice about the need for caution during adaptation to new eyeglasses," the team concludes.

SOURCE: Journal of the American Geriatrics Society, February 2007.