PURPOSE To examine the cross-sectional and longitudinal associations between visual impairment (VI) and falls in United States older adults. DESIGN Retrospective cross-sectional and cohort study. METHODS This study utilized data from the National Health and Aging Trends Study 2021 and 2022. Participants were Medicare beneficiaries ≥71 years. Exposures were any VI - defined as distance or near VI (>0.3 logMAR), or contrast sensitivity (CS) impairment (<1.55 logCS) -and changes in distance visual acuity ([DVA], logMAR/y), near visual acuity ([NVA], logMAR/y), or CS (logCS/y). Outcomes were self-reported falls in the past 12 months. RESULTS 2822 participants were included in the analysis. At baseline, adults with any VI had greater rates of falls (rate ratio = 1.16, 95% CI = 1.04-1.30) and multiple falls (rate ratio = 1.23, 95% CI = 1.01-1.49) than peers without VI. In longitudinal analysis, adults with any VI at baseline did not have a greater risk of falls or multiple falls in the following year compared to peers without VI; only worse CS (hazard ratio [HR] = 1.03, 95% CI = 1.01-1.06, per 0.1 logCS worse) and DVA (HR = 1.11, 95% CI = 1.04-1.18, per 0.1 logMAR worse) were associated with a greater risk of falls and multiple falls, respectively. However, in other models, change in NVA (HR = 1.04, 95% CI = 1.01-1.08, per 0.1 logMAR worse/y) was associated with greater fall risk over the follow-up period. Further, change in CS (HR = 1.11, 95% CI = 1.05-1.18, per 0.1 logCS worse/y) was associated with a greater risk of multiple falls, while changes in DVA and NVA were not. CONCLUSIONS Older United States adults with VI are more likely to experience a fall, with various components of their vision influencing the fall risk.

中文翻译：

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美国视力障碍老年人的跌倒和多发性跌倒。


目的 检查美国老年人视力障碍 （VI） 与跌倒之间的横断面和纵向关联。设计 回顾性横断面和队列研究。方法 本研究利用了 2021 年和 2022 年国家健康与老龄化趋势研究的数据。参与者是 71 岁的 Medi≥care 受益人。暴露是任何 VI - 定义为远距离或近 VI （>0.3 logMAR） 或对比敏感度 （CS） 损伤 （<1.55 logCS） - 以及远视力 （[DVA]、logMAR/y）、近视力 （[NVA]、logMAR/y） 或 CS （logCS/y） 的变化。结局是过去 12 个月内自我报告的跌倒。结果 2822 名参与者被纳入分析。在基线时，与没有 VI 的同龄人相比，患有任何 VI 的成年人跌倒率 （率比 = 1.16,95% CI = 1.04-1.30） 和多次跌倒率 （率比 = 1.23,95% CI = 1.01-1.49） 更高。在纵向分析中，与没有 VI 的同龄人相比，基线时有任何 VI 的成年人在下一年跌倒或多次跌倒的风险并不更高;只有更差的 CS （风险比 [HR] = 1.03,95% CI = 1.01-1.06，每恶化 0.1 logCS）和 DVA （HR = 1.11,95% CI = 1.04-1.18，每恶化 0.1 logMAR）分别与更大的跌倒和多次跌倒风险相关。然而，在其他模型中，NVA 的变化 （HR = 1.04,95% CI = 1.01-1.08，每 0.1 logMAR 恶化/y） 与随访期间更高的跌倒风险相关。此外，CS 的变化 （HR = 1.11,95% CI = 1.05-1.18，每 0.1 logCS 恶化/y） 与更大的多次跌倒风险相关，而 DVA 和 NVA 的变化则不然。结论 患有 VI 的美国老年人更容易跌倒，他们视力的各个组成部分都会影响跌倒风险。