Dual visual impairment and contrast sensitivity among community-dwelling older adults: a cross-sectional study from the PrevQuedas Brazil trial

Abstract

Objective: To investigate the importance of improving visual assessment for community-dwelling older adult fallers. Methods: This cross-sectional study included eligible community-dwelling older adults (> 60 years of age) from the PrevQuedas Brazil clinical trial who had suffered at least 1 fall in the last 12 months (n = 703). We evaluated visual acuity and contrast sensitivity using the Snellen E chart and low contrast visual acuity tests; those with both impairment types were considered to have dual visual impairment. Results: Visual acuity, low contrast sensitivity, and dual visual impairment were associated with recurrent falls (OR 1.85); visual impairment was more prevalent among the oldest old. Approximately 90.00% of the participants reported using glasses, and 63.80% used multifocal lenses. Dual impairment was identified in 143 (20.30%) participants. In multivariate logistic regression, the predictive variables for recurrent falls were low contrast sensitivity (95%CI 1.15–2.47), dual visual impairment (95%CI 1.16–2.83), and self-perceived fall risk (95%CI 1.16–2.46) which was measured using the Falls Efficacy Scale-International. Conclusion: Older adults with dual visual impairment are more likely to suffer recurrent falls. Low contrast sensitivity is crucial for fall risk assessment. Trial registration: ClinicalTrials.gov (NCT01698580).