A recent study showed that patients with worse visual acuity or a history of cataracts are more likely to develop balance problems. Previous studies observed the significant role the visual system plays in maintaining postural control with increasing age, which subjects visually impaired older adults to an increased risk of falls, nursing home admission and mortality.
Researchers used baseline and three-year follow-up data from the Canadian Longitudinal Study on Aging. A total of 30,097 adults 45 to 85 years old participated in their study, with 27,765 (92%) completing the three-year follow-up. The one-leg balance test—requiring participants to remain standing on one leg for 60 seconds to pass—was used to measure balance. The ETDRS letter chart at a two-meter distance was used to measure visual acuity.
Of the 12,158 people who passed the balance test at baseline, 18% were unable to do the same at the three-year follow-up. Participants had 15% higher odds of failing the balance test at follow-up for each line worse of visual acuity. Those with a history of or current cataracts were also more likely to fail the test. Two other ocular diseases—AMD and glaucoma—did not correlate with risk of falls, the study found.
“Those who were older, smoked, were obese, had diabetes, ADL limitations, or stroke were more likely to fail the balance test at follow-up,” the researchers wrote in their paper. “[They] had worse baseline visual acuity compared to those who passed. All three eye diseases at baseline were associated with failing the balance test at follow-up including having a past or current cataract, or AMD, or glaucoma.” However, unlike cataracts, AMD and glaucoma were not associated with failure of the test at baseline after adjustment. One reason for this could be because eye diseases were self-reported by participants or may have been in early stages.
Older patients with visual impairments or removed or unremoved cataracts are more likely to experience the onset of balance problems. Interventions should be considered to help improve balance for the elderly population who often have worse visual acuity and are more susceptible to falls and injury.
Kahiel Z, Grant A, Aubin MJ, et al. Vision, eye disease, and the onset of balance problems: the canadian longitudinal study on aging. American Journal of Ophthalmology. 2021. [Epub ahead of print].