The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study

Abstract BackgroundFalls 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 confoundin...

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Main Authors: Kasem Seresirikachorn, Rachasak Somyanonthanakul, Matthew Johnson, Panisa Singhanetr, Jiraporn Gatedee, David Friedman, Nazlee Zebardast
Format: Article
Language:English
Published: JMIR Publications 2025-07-01
Series:JMIR Aging
Online Access:https://aging.jmir.org/2025/1/e68771
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author Kasem Seresirikachorn
Rachasak Somyanonthanakul
Matthew Johnson
Panisa Singhanetr
Jiraporn Gatedee
David Friedman
Nazlee Zebardast
author_facet Kasem Seresirikachorn
Rachasak Somyanonthanakul
Matthew Johnson
Panisa Singhanetr
Jiraporn Gatedee
David Friedman
Nazlee Zebardast
author_sort Kasem Seresirikachorn
collection DOAJ
description Abstract BackgroundFalls 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. ObjectiveThe 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. MethodsThis 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. ResultsA 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 (PP ConclusionsBoth 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.
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spelling doaj-art-1c4e041ff57a45ff8f8bfaa72f16c42a2025-08-20T03:41:01ZengJMIR PublicationsJMIR Aging2561-76052025-07-018e68771e6877110.2196/68771The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal StudyKasem Seresirikachornhttp://orcid.org/0000-0001-7963-5591Rachasak Somyanonthanakulhttp://orcid.org/0000-0003-4532-0131Matthew Johnsonhttp://orcid.org/0000-0002-7999-3273Panisa Singhanetrhttp://orcid.org/0000-0001-9118-8499Jiraporn Gatedeehttp://orcid.org/0009-0003-1365-9904David Friedmanhttp://orcid.org/0000-0002-2055-5797Nazlee Zebardasthttp://orcid.org/0000-0003-1763-9401 Abstract BackgroundFalls 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. ObjectiveThe 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. MethodsThis 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. ResultsA 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 (PP ConclusionsBoth 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.https://aging.jmir.org/2025/1/e68771
spellingShingle Kasem Seresirikachorn
Rachasak Somyanonthanakul
Matthew Johnson
Panisa Singhanetr
Jiraporn Gatedee
David Friedman
Nazlee Zebardast
The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
JMIR Aging
title The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
title_full The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
title_fullStr The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
title_full_unstemmed The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
title_short The Impact of Vision Impairment on Self-Reported Falls Among Older US Adults: Cross-Sectional and Longitudinal Study
title_sort impact of vision impairment on self reported falls among older us adults cross sectional and longitudinal study
url https://aging.jmir.org/2025/1/e68771
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