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PALs more likely than bifocals to improve balance in seniors

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SAN DIEGO – Progressive-addition lenses (PALs) are more likely than bifocals to improve mobility and balance in older people, according to a poster presentation at the 2005 American Academy of Optometry meeting here Saturday.

The study, authored by Carol Lakkis, OD, of the University of Melbourne, found that PALS were especially beneficial in the areas of dynamic postural stability and coordinated stability.

This progressive, randomized double-masked crossover trial looked at 20 full-time bifocal wearers at least 65 years old. All subjects had a distance visual acuity (VA) of 20/30 or better in each eye. All patients had previously worn bifocals for a year or longer, but had no previous experience with PALs. All had active lifestyles as determined by the Physical Activity Scale for the Elderly (PASE).

Two PAL designs were worn by the patients for 3 weeks each, with a 2-week washout period. The two PALs worn were Essilor’s Definity and Essilor’s Varilux Comfort.

At each visit, the patients were measured for the following: high- and low-contrast distance VA and near VA (logMAR), postural sway and coordinated stability, and walking speed (8-m straight line, 25 m indoor obstacle course and step climbing). Each patient was also given the Independent Mobility Questionnaire (IMQ) and the Modified Falls Efficiency Questionnaire (MFES).

At the conclusion of the study, subjects were asked to choose whether they wished to continue wearing PALs or have new bifocals fitted. Those who chose PALs were followed up at 3 months. The study found that dynamic postural stability (sway) was significantly better with one of the PALs compared to bifocals (p<0.05). Coordinated stability showed significant superiority with both PALs at 3 weeks compared to bifocals. No significant differences in walking speed were found between the two lens designs.

At the conclusion of the study, all subjects chose to continue wearing PALs. At 3-month follow-up, 76% of patients were still wearing PALs full-time, and 24% were wearing PALS part-time and bifocals part-time.