Older adults who wear progressive-addition lenses at increased risk for falls
Key takeaways:
- Older adults who wore progressive-addition lenses had the greatest fall rate.
- PALs wearers were two times more likely to fall vs. other types of multifocal glasses wearers.
Older adults who wear progressive-addition lens glasses appeared at increased risk for falls compared with older adults who wear bifocals, according to a study published in Optometry and Vision Science.
Previous research shows that multifocal glasses, including those with bifocal, trifocal or progressive addition lenses (PALs), are associated with trips and falls among older people, especially when they are walking on stairs and in unfamiliar settings. This may be because multifocal glasses blur distant objects and can cause visual distortions.
“To date, no studies have examined whether all types of multifocal glasses are equally associated with falls,” Stephen R. Lord, PhD, DSc, senior principal research fellow at Neuroscience Research Australia in Sydney and conjoint professor in the School of Population Health at UNSW Sydney, and colleagues wrote.
This inspired the researchers to perform a retrospective analysis of data from the VISIBLE randomized controlled trial, conducted from 2005 to 2008, to determine whether fall rates differ among older bifocal, trifocal and PALs wearers.
They included 281 participants aged 65 to 94 years (women, n = 195; mean age, 80.3 years; standard deviation [SD] = 6.8 years) who were at increased risk for falls and wore one type of multifocal three or more times per week. Most were bifocal wearers (n = 170), followed by PALs (n = 78) and trifocals (n = 33) wearers.
The researchers measured participants’ visual acuity, sensorimotor function and balance (Physiological Profile Assessment), cognitive function (Mini Mental State Examination), functional mobility (Timed Up and Go test) and physical activity level (self-reported using Adelaide Activities Profile) and followed them for 13 months to determine number of falls.
At baseline, bifocal wearers were typically older than the other groups. Also, the bifocal and trifocal wearers had better depth perception than PALs wearers.
Among the 268 participants with 6 or more months of follow-up, 61 fell once, 45 fell twice and 54 fell three or more times. The researchers found that 31.5% of bifocal wearers suffered multiple falls compared with 46.9% of trifocal and 44.6% of PALs wearers.
The fall rate of participants who wore PALs was greatest (2.31; SD, 4.11) compared with bifocal wearers (1.61; SD, 3.23) and trifocal wearers (1.59; SD, 1.67).
According to a binary logistic regression analysis adjusted for established fall risk factors, such as age, sex and prior falls, participants who regularly wore PALs were more than two times more likely to suffer multiple falls compared with regular wearers of bifocals (OR = 2.23; P = .03), with similar results in a negative binomial regression analysis adjusted for the same covariates (incident rate ratio = 1.56; P = .048).
Also, although there was an indication that trifocal wearers were more likely to experience falls vs. bifocal wearers, the difference was not statistically significant.
Lord and colleagues observed several limitations to this study, including: this analysis used data from an older study not powered for the current study hypotheses and that the glasses used in the initial study may not reflect current prescription use.
“Education of the risks posed by progressive-addition lens glasses and training in optimal glasses use, including the use of single lens distance glasses when outside the home, may help protect older people from falls,” Lord and colleagues wrote.
Collapse