Predictors of falls in the Melbourne visual impairment project

Objective: To assess factors associated with falls in the past month, including visual acuity and other vision-related variables. Methods: A household census was used to recruit permanent residents aged 40 years and older for baseline examinations of the Melbourne Visual Impairment Project conducted from 1992-94. At the five-year follow-up examinations, returning participants were asked to recall all falls that they had ever experienced and also how many falls they had experienced in the past month. Falls history was divided into those that occurred at home and away from home. Standardised examination of visual acuity was performed. Results: Of the original cohort of 3,271, 231 (7.1%)were reported to have died, leaving 3,040 eligible. Of these, 2,594 (85%) were examined, 51 (2%) had moved interstate or overseas, 83 (3%) could not be traced, and 312 (10%) refused to participate. A history of having ever fallen at home was reported by 466 (20%) participants, and 406 (17.3%) reported having fallen away from home at least once. Five per cent of the cohort (129/2,343) had fallen in the previous month. Factors significantly related to falls at home in the past month in a multivariate logistic regression model included age (OR=1.56 for 10-year age groups) and nuclear cataract (OR=2.87). Conclusions: Irrespective of visual acuity, cataract is major risk factor for falls at home. Implications: Interventions aimed at decreasing the incidence of falls in the community should include assessment of both visual acuity and cataract status and referral for treatment if functional impairment is evident.