Global burden of fall and associated factors among individual with low vision: A systematic-review and meta-analysis

Introduction Low vision has a significant global health problem that impacts the personal, economical, psychological, and social life of an individual. Each year around 684 000 individuals die from falls, 80% of these deaths occur are in low- and middle-income countries. The risk of falling significantly increases with visual impairment. This review aimed to determine the global pooled prevalence of fall and associated factors among individuals with low vision. Methods and materials Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL and, Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to report the findings. Quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using a random-effects method using the STATA™ Version 14 software. Result Thirty-five (35) studies from different regions involving 175,297 participants included in this meta-analysis. The overall pooled global prevalence fall among individual with low vision was17.7% (95% CI: 16.4–18.9) whereas the highest prevalence was 35.5%; (95% CI: 28.4–42.5) in Australia and the lowest was 19.7%; (95% CI: 7.6–31.8) seen in South America. Fear of falling (OR: 0.16(95%CI 0.09–0.30), and severity of visual impairment (OR: 0.27(95%CI (0.18–0.39) increases the odds of falling. Conclusion As one cause of accidental death, the prevalence of falls among individuals with low vision is high. Fear of falling and severity of falling increases the odds of falling. Different stakeholders should give due attention and plan effective strategies to reduce the fall among this population.

[1]  Rami A. Al-Dwairi,et al.  The Effect of Visual Impairment and Its Severity on Vision-Related and Health-Related Quality of Life in Jordan: A Comparative Cross-Sectional Study , 2023, Journal of multidisciplinary healthcare.

[2]  Edith N Botchway,et al.  Comparative Analysis of Health- and Vision-Related Quality of Life Measures among Trinidadians with Low Vision and Normal Vision—A Cross-Sectional Matched Sample Study , 2023, International journal of environmental research and public health.

[3]  S. Koskinen,et al.  Impact of vision on generic health‐related quality of life – A systematic review , 2023, Acta ophthalmologica.

[4]  G. Belete,et al.  Self-Reported Fall-Related Injury and Its Associated Factors among Adults with Visual Impairment Attending St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia , 2023, Ethiopian journal of health sciences.

[5]  R. R. Singh,et al.  Visual impairment and falls among older adults and elderly: evidence from longitudinal study of ageing in India , 2022, BMC public health.

[6]  D. García-Lozada,et al.  Causes of low vision in children: A systematic review. , 2022, Archivos de la Sociedad Espanola de Oftalmologia.

[7]  Hao Li,et al.  Risk factors of falls in elderly patients with visual impairment , 2022, Frontiers in Public Health.

[8]  H. Boagey,et al.  Psychological Impact of Vision Loss , 2022, Journal of Mental Health & Clinical Psychology.

[9]  C. Sabanayagam,et al.  Associations between visual impairment, incident falls and fall frequency among older asians: longitudinal findings from the Singapore Epidemiology of Eye Diseases study , 2022, British Journal of Ophthalmology.

[10]  Alyne de Souza Dias,et al.  ACCIDENTS CAUSED BY FALLS IN THE ELDERLY PEOPLE: A PUBLIC HEALTH PROBLEM , 2022, Journal Health and Technology - JHT.

[11]  N. Salari,et al.  Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis , 2022, Journal of Orthopaedic Surgery and Research.

[12]  J. Gussekloo,et al.  Visual impairment as a predictor for deterioration in functioning: the Leiden 85-plus Study , 2022, BMC Geriatrics.

[13]  T. Asai,et al.  The association between fear of falling and occurrence of falls: a one-year cohort study , 2022, BMC Geriatrics.

[14]  Mary E. Schmitz-Brown,et al.  Barriers to Low-Vision Rehabilitation Services for Visually Impaired Patients in a Multidisciplinary Ophthalmology Outpatient Practice , 2021, Journal of ophthalmology.

[15]  E. Wilson,et al.  Prevalence of Falls in Patients Presenting to an Ophthalmic Outpatients Department- A Surveillance Study , 2021, The British and Irish orthoptic journal.

[16]  Cassie A. Ludwig,et al.  Fall risk in patients with pseudophakic monovision. , 2021, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[17]  S. Harding,et al.  Visual risk factors for falls in older adults: a case-control study , 2021, BMC Geriatrics.

[18]  F. Çınar,et al.  Elderly patients and falls: a systematic review and meta-analysis , 2021, Aging Clinical and Experimental Research.

[19]  Moges Gashaw,et al.  Injury Related to Fall and Its Predictors among Medically Diagnosed Adults with Visual Impairment in Ethiopia: An Observational Cross-Sectional Study , 2021, Advances in orthopedics.

[20]  Monica S. Perlmutter,et al.  Rate of falls, fear of falling, and avoidance of activities at-risk for falls in older adults with glaucoma. , 2021, American journal of ophthalmology.

[21]  Tueng T. Shen,et al.  Trends in prevalence of blindness and distance and near vision impairment over 30 years: an analysis for the Global Burden of Disease Study , 2020, The Lancet. Global health.

[22]  E. Mayo-Wilson,et al.  The PRISMA 2020 statement: an updated guideline for reporting systematic reviews , 2020, BMJ.

[23]  D. Friedman,et al.  Falls and visual impairment among elderly residents in ‘homes for the aged’ in India , 2020, Scientific Reports.

[24]  T. Vos,et al.  Global Prevalence of Blindness and Distance and Near Vision Impairment in 2020: progress towards the Vision 2020 targets and what the future holds. , 2020 .

[25]  M. Bruce,et al.  Fall Worry Restricts Social Engagement in Older Adults , 2020, Journal of aging and health.

[26]  C. How,et al.  Approach to falls among the elderly in the community. , 2020, Singapore medical journal.

[27]  Joelle C. Ruthig,et al.  A longitudinal study of the negative impact of falls on health, well-being, and survival in later life: the protective role of perceived control , 2020, Aging & mental health.

[28]  Amare Minyihun,et al.  Self-reported fall and associated factors among adult people with visual impairment in Gondar, Ethiopia: a cross-sectional study , 2019, BMC Public Health.

[29]  M. Gissler,et al.  Low vision status and declining vision decrease Health-Related Quality of Life: Results from a nationwide 11-year follow-up study , 2019, Quality of Life Research.

[30]  M. Sailaja,et al.  Barriers and enablers to low vision care services in a tertiary eye care hospital: A mixed method study , 2019, Indian journal of ophthalmology.

[31]  Sumitra S. Khandelwal,et al.  Ophthalmic Conditions Associated with Inpatient Falls among Veterans. , 2018, Optometry and vision science : official publication of the American Academy of Optometry.

[32]  Brian C. Stagg,et al.  Prevalence of Falls and Fall‐Related Outcomes in Older Adults with Self‐Reported Vision Impairment , 2018, Journal of the American Geriatrics Society.

[33]  S. Krishnaiah,et al.  Impact of blindness due to cataract in elderly fallers: findings from a cross-sectional study in Andhra Pradesh, South India , 2018, BMC Research Notes.

[34]  Farhan Khashim Alswailmi,et al.  Global prevalence and causes of visual impairment with special reference to the general population of Saudi Arabia , 2018, Pakistan journal of medical sciences.

[35]  K. Naidoo,et al.  Global prevalence of visual impairment associated with myopic macular degeneration and temporal trends from 2000 through 2050: systematic review, meta-analysis and modelling , 2018, British Journal of Ophthalmology.

[36]  Oh-Sang Kwon,et al.  Ageing vision and falls: a review , 2018, Journal of Physiological Anthropology.

[37]  May M Bakkar,et al.  Clinical characteristics and causes of visual impairment in a low vision clinic in northern Jordan , 2018, Clinical ophthalmology.

[38]  S. Khanal,et al.  Prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study , 2018, BMC Ophthalmology.

[39]  S. Leat,et al.  Prevalence of vision loss among hospital in‐patients; a risk factor for falls? , 2018, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[40]  M. He,et al.  Association of Socioeconomics With Prevalence of Visual Impairment and Blindness , 2017, JAMA ophthalmology.

[41]  P. Melillo,et al.  Identifying fallers among ophthalmic patients using classification tree methodology , 2017, PloS one.

[42]  M. Kang,et al.  Visual Acuity and Falls in South Korea: Korean National Health and Nutrition Examination Survey 2008-2012 , 2016 .

[43]  Alberto Diniz-Filho,et al.  Association of Fast Visual Field Loss With Risk of Falling in Patients With Glaucoma. , 2016, JAMA ophthalmology.

[44]  J. Stevens,et al.  Falls Among Persons Aged ≥65 Years With and Without Severe Vision Impairment - United States, 2014. , 2016, MMWR. Morbidity and mortality weekly report.

[45]  Jyothi Thomas,et al.  Awareness, knowledge, and barriers to low vision services among eye care practitioners , 2016, Oman journal of ophthalmology.

[46]  S. Leat,et al.  Reprint of: Barriers to accessing low-vision care: the patient's perspective. , 2015, Canadian journal of ophthalmology. Journal canadien d'ophtalmologie.

[47]  Z. Mosallanezhad,et al.  Falls and postural control in older adults with cataracts , 2015, Medical journal of the Islamic Republic of Iran.

[48]  R. Marks Falls Among the Elderly and Vision: A Narrative Review , 2014 .

[49]  Bruce Guthrie,et al.  Visual impairment is associated with physical and mental comorbidities in older adults: a cross-sectional study , 2014, BMC Medicine.

[50]  Q. To,et al.  Prevalence and Visual Risk Factors for Falls in Bilateral Cataract Patients in Ho Chi Minh City, Vietnam , 2014, Ophthalmic epidemiology.

[51]  R. Luben,et al.  Visual acuity, self-reported vision and falls in the EPIC-Norfolk Eye study , 2013, British Journal of Ophthalmology.

[52]  Byoung-Jin Jeon,et al.  The Effects of Balance of Low Vision Patients on Activities of Daily Living , 2013, Journal of physical therapy science.

[53]  Rebecca J. Reed-Jones,et al.  Vision and falls: a multidisciplinary review of the contributions of visual impairment to falls among older adults. , 2013, Maturitas.

[54]  S. Lord,et al.  Depressive symptoms in addition to visual impairment, reduced strength and poor balance predict falls in older Taiwanese people. , 2012, Age and ageing.

[55]  S. Kivelä,et al.  Eye Diseases and Impaired Vision as Possible Risk Factors for Recurrent Falls in the Aged: A Systematic Review , 2012, Current gerontology and geriatrics research.

[56]  G. V. van Rens,et al.  The impact of low vision on activities of daily living, symptoms of depression, feelings of anxiety and social support in community-living older adults seeking vision rehabilitation services , 2011, Quality of Life Research.

[57]  J. Lovie-Kitchin,et al.  Inferior Field Loss Increases Rate of Falls in Older Adults with Glaucoma , 2011, Optometry and vision science : official publication of the American Academy of Optometry.

[58]  Daryl R. Tabrett,et al.  Factors influencing self-reported vision-related activity limitation in the visually impaired. , 2011, Investigative ophthalmology & visual science.

[59]  Joanne M Wood,et al.  Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration. , 2011, Investigative ophthalmology & visual science.

[60]  T Pey,et al.  Visual loss and falls: a review , 2010, Eye.

[61]  S. Azen,et al.  Central and peripheral visual impairment and the risk of falls and falls with injury. , 2010, Ophthalmology.

[62]  Ecosse Lamoureux,et al.  The relationship between visual function, duration and main causes of vision loss and falls in older people with low vision , 2010, Graefe's Archive for Clinical and Experimental Ophthalmology.

[63]  P. Chou,et al.  Visual Impairment and Falls in the Elderly: The Shihpai Eye Study , 2008, Journal of the Chinese Medical Association : JCMA.

[64]  J. Lovie-Kitchin,et al.  Visual field loss and falls among older adults with glaucoma , 2008 .

[65]  Tien Yin Wong,et al.  Visual impairment, causes of vision loss, and falls: the singapore malay eye study. , 2008, Investigative ophthalmology & visual science.

[66]  T. Rantanen,et al.  Lowered vision as a risk factor for injurious accidents in older people , 2008, Aging clinical and experimental research.

[67]  B. Munoz,et al.  Visual field loss increases the risk of falls in older adults: the Salisbury eye evaluation. , 2007, Investigative ophthalmology & visual science.

[68]  L. A. Chiasson,et al.  Risk of falls and motor vehicle collisions in glaucoma. , 2007, Investigative ophthalmology & visual science.

[69]  Ecosse L Lamoureux,et al.  Barriers to accessing low vision services , 2003, Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians.

[70]  C. McCarty,et al.  The Risks of Everyday Life: Predictors of falls in the Melbourne Visual Impairment Project , 2002 .

[71]  S. Lord,et al.  Visual Risk Factors for Falls in Older People , 2001, Age and ageing.

[72]  R. Cumming,et al.  Visual impairment and risk of hip fracture. , 2000, American journal of epidemiology.

[73]  S J Leat,et al.  What is low vision? A re-evaluation of definitions. , 1999, Optometry and vision science : official publication of the American Academy of Optometry.

[74]  R. Cumming,et al.  Visual Impairment and Falls in Older Adults: The Blue Mountains Eye Study , 1998, Journal of the American Geriatrics Society.

[75]  A. Best The management of low vision in children , 1995 .

[76]  R. Glynn,et al.  Falls in elderly patients with glaucoma. , 1991, Archives of ophthalmology.

[77]  M. Yaseri,et al.  Prevalence of Low Vision and Blindness in Socio-Economic Levels and Association of them in Varamin City 2009 , 2013 .

[78]  S. Sindhu,et al.  Fall-related Factors among Older, Visually-Impaired Thais , 2013 .

[79]  R. Sergott Central and Peripheral Visual Impairment and the Risk of Falls and Falls with Injury , 2010 .

[80]  A. Coleman Sources of binocular suprathreshold visual field loss in a cohort of older women being followed for risk of falls (an American Ophthalmological Society thesis). , 2007, Transactions of the American Ophthalmological Society.