Improving vision to prevent falls: a randomized trial

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More than 30% of older Australians fall over at least once a year. Poor eyesight, another very common problem among older Australians, increases the risk of falling. In fact, recent evidence from the Blue Mountains Eye Study suggests that poor vision is one of the strongest risk factors for falls and fractures yet identied. Our project is designed to assess whether improving vision will decrease the chance of falls and fractures. We will recruit 1200 people aged 75 years and over from among those attending community-based aged care services in the inner western suburbs of Sydney. If they consent to participate, people will be randomly allocated to either an intervention or control group. Those in the intervention group will receive a simple, yet comprehensive, series of vision and eye tests. These tests will be done by an optometrist, either in subjects' homes or at the study centre. Our previous research suggests that nearly 50% of subjects will benefit from having new glasses and 10% might require cataract surgery. If necessary, treatment will be paid for from study funds. Some vision problems cannot be fixed. In these cases, an occupational therapist will arrange appropriate home modifications to improve vision-related function. Subjects will be followed-up for 12 months to assess the frequency of falls in the intervention and control groups. We hope to find a 33% reduction in falls in the intervention group. We will follow subjects for a further year to identify fractures.