Falls are one of the leading causes of injuries and fatalities in older adults, with at least a third of people over the age of 65 reporting a fall at least once per year, with around half of these people reporting multiple falls. Falls rates are particularly high in older and frailer people, with falls accounting for a large number of accidental deaths. Falling thus represents an important health issue in our older population.
Visual impairment is an important risk factors for falls. Visual impairment impacts on mobility performance, resulting in increased difficulties in obstacle avoidance and locomotion planning. The visual system is also a key sensory contributor to postural control; older adults with visual impairment show greater postural instability. Importantly, postural instability is a risk factor for falls.
Our research seeks to examine the associations between visual impairment from a range of ocular diseases and balance, mobility and falls risk.
Ocular Disease & Falls
Falls are common among older adults with visual impairment, and are linked to severity of vision loss. Our research on falls among older adults with glaucoma has highlighted the importance of the inferior visual field region in falls risk and postural stability, and assists in identifying older adults with glaucoma at risk of future falls, for whom potential interventions should be targeted. Our research on falls among older adults with age-related macular degeneration has shown that increased visual impairment was significantly associated with an increased incidence of falls and other injuries. Reduced contrast sensitivity was shown to be significantly associated with increased rates of falls, injurious falls and injuries in this group.
Fear of Falling
There are also important psychological consequences following a fall, including depression, anxiety, activity restriction, and fear of falling. Fear of falling affects 20 to 40% of community-dwelling older adults and is not limited to those who have previously experienced a fall. Older adults who experience fear of falling may subsequently restrict their physical and everyday activities, which can lead to functional decline, depression, increased falls risk, and reduced quality of life.
Our research has been investigating fear of falling among older adults with age-related macular degeneration. These findings will provide a better understanding of factors associated with fear of falling specific to older adults with vision impairment: including risk factors for development or progression of fear of falling, and consequences of fear of falling specific to this population.
- Kasneci, Enkelejda, Black, Alexander, Wood, Joanne (2017) Eye-tracking as a tool to evaluate functional ability in everyday tasks in glaucoma Journal of Ophthalmology, 2017, pp.Article number: 6425913 1-10.
- White, Ursula, Black, Alexander, Wood, Joanne, Delbaere, Kim (2015) Fear of falling in vision impairment Optometry and Vision Science, 92 (6), pp.730-735.
- Black, Alexander, Kimlin, Janessa, Wood, Joanne (2014) Stepping accuracy and visuomotor control among older adults : effect of target contrast and refractive blur Ophthalmic and Physiological Optics, 34 (4), pp.470-478.
- Eramudugolla, Ranmalee, Wood, Joanne, Anstey, Kaarin (2013) Co-morbidity of depression and anxiety in common age-related eye diseases : a population-based study of 662 adults Frontiers in Aging Neuroscience, 5, pp.Article number: 56 1-9.
- Black, Alexander, Wood, Joanne, Lovie-Kitchin, Jan (2011) Inferior field loss increases rate of falls in older adults with glaucoma Optometry and Vision Science, 88 (11), pp.1275-1282.
- Wood, Joanne, Lacherez, Philippe, Black, Alexander, Cole, Michael, Boon, Mei, Kerr, Graham (2011) Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration Investigative Ophthalmology and Visual Science, 52 (8), pp.5088-5092.
- Cole, Michael, Silburn, Peter, Wood, Joanne, Kerr, Graham (2011) Falls in Parkinson’s disease : evidence for altered stepping strategies on compliant surfaces Parkinsonism and Related Disorders, 17 (8), pp.610-616.
- Black, Alexander, Wood, Joanne, Lovie-Kitchin, Jan (2011) Inferior visual field reductions are associated with poorer functional status among older adults with glaucoma Ophthalmic and Physiological Optics, 31 (3), pp.283-291.
- Cole, Michael, Silburn, Peter, Wood, Joanne, Worringham, Charles, Kerr, Graham (2010) Falls in Parkinson's disease : kinematic evidence for impaired head and trunk control Movement Disorders, 25 (14), pp.2369-2378.
- Kerr, Graham, Worringham, Charles, Cole, Michael, Lacherez, Philippe, Wood, Joanne, Silburn, Peter (2010) Predictors of future falls in Parkinson disease Neurology, 75 (2), pp.116-124.
- Wood, Joanne, Chaparro, Alex, Anstey, Kaarin, Lacherez, Philippe, Chidgey, Aaron, Eisemann, Jared, Gaynor, Alison, La, Peter (2010) Simulated visual impairment leads to cognitive slowing in older adults Optometry and Vision Science, 87 (12), pp.1037-1043.
- Anstey, Kaarin, Wood, Joanne, Kerr, Graham, Caldwell, Haley, Lord, Stephen (2009) Different cognitive profiles for single compared with recurrent fallers without Dementia Neuropsychology, 23 (4), pp.500-508.
- Wood, Joanne, Lacherez, Philippe, Black, Alexander, Cole, Michael, Boon, Mei, Kerr, Graham (2009) Postural stability and gait among older adults with age-related maculopathy Investigative Ophthalmology and Visual Science, 50 (1), pp.482-487.
- Black, Alexander, Wood, Joanne, Caruso, Danielle, Corrigan, Katherine, Hur, Janette, Sharma, Shraddha, Wu, J. M. (2009) The effect of monocular and binocular cataract blur on postural stability among older adults Association for Research in Vision and Ophthalmology (ARVO) 2009 Annual Meeting, pp.1-1.
- Black, Alexander, Wood, Joanne, Lovie-Kitchin, Jan, Newman, Beth (2009) Visual impairment, postural stability and falls among older adults with glaucoma 12th Scientific Meeting in Optometry, pp.52-52.
- Kerr, G., Cole, M. H., Lacherez, P., Silburn, P., Wood, J. M., Worringham, C. J. (2008) Can falls be accurately predicted in people with Parkinson’s disease? 3rd Australian and New Zealand Falls Prevention (ANZFP) Conference.
- Black, Alexander, Wood, Joanne, Lovie-Kitchin, Jan, Newman, Beth (2008) Visual field loss and falls among older adults with glaucoma Investigative Ophthalmology and Visual Science, 49 (5), pp.5458-5458.
- Lacherez, Philippe, Wood, Joanne, Kerr, Graham (2008) Does activity level mediate or suppress the association between fear of falling and falls? Letter to the Editor Preventive Medicine, 46 (6), pp.609-609.
- Wood, Joanne, Black, Alexander, Boon, Mei, Cole, Michael, Kerr, Graham, Lacherez, Philippe (2008) Postural stability, gait and visual function in older adults with age-related maculopathy Australian and New Zealand Falls Prevention Conference (3rd), pp.1-1.
- Wood, J.M., Lacherez, P., Black, A., Cole, M.H., Boon, M.Y., Kerr, G. (2008) Postural stability and gait in age-related maculopathy 9th International Conference on Low Vision.
- Black, Alexander, Wood, Joanne (2005) Vision and falls: the Optometrists role Clinical and Experimental Optometry, 88 (4), pp.212-222.
- Black, Alex, Wood, Joanne M. (2005) The relationship between glaucoma and falls in older Australians : a prospective study 4th National Conference for Emerging Researchers in Ageing, pp.61-64.