Poor vision and home hazards drastically increase fall risk for older adults, study finds

Older adults with severe vision loss who live in homes with multiple hazards are three to four times more likely to experience a fall, according to a recent study.

Using the National Health and Aging Trends Study, researchers at the University of Michigan looked at data from more than 4,600 Medicare beneficiaries 65 and older. Participants completed visual function tests and their homes were assessed for hazards such as missing grab bars, tripping risks and broken flooring.

More than half of the participants were living with at least one hazard in their home. Around 47% of homes lacked grab bars, while 9.5% had tripping hazards and 4.5% had broken flooring. Roughly 7% of the homes had two hazards.

“When an older adult with normal vision lives in a home with multiple hazards, fall risk is relatively low, but with high levels of vision impairment, fall risk increases threefold to fourfold,” said lead study author Shu Xu, a postdoctoral fellow at U-M’s Institute for Social Research. “Importantly, even among those with high levels of vision impairment, fall risk only increases significantly when home hazards are present.”

Xu and her colleagues offer five simple changes to help protect older adults from falling at home:

1. Undergo regular eye exams and wear the right eyewear as recommended.
2. Install grab bars in bathrooms near toilets and tubs/showers and use non-slip bathmats.
3. Clear walking paths by removing or taping down loose rugs, moving electrical cords, and decluttering stairs and hallways.
4. Fix damaged flooring by repairing torn carpet, broken tiles or uneven floorboards.
5. Use bright, even lighting – especially in hallways and on stairs. Add nightlights near bathrooms and bedrooms.

“Our study emphasizes the need to include the home environment as a key component of fall prevention, especially for older adults with vision loss,” Xu said. “If we focus only on improving vision, we may overlook a group at very high risk: people who have both poor vision and hazards in their homes.”

The study was published in the journal JAMA Ophthalmology.