June 5, 2014

New Glasses for Elderly Often Equals Increase in Fall Risk

When I wrote about antidepressants possibly causing falls for the elderly, binocular vision disorders is higher than expected in the elderly, most binocular vision disorders are treatable with glasses, vision therapy, or occasionally surgery. It is recommended that people keep their glasses up-to-date with regular eye examinations. This will avoid large prescription changes and is a good way to maintain good vision, decrease risk of falls, and maintain a good quality of life as you age.

Now we have a non-scientific review in optometry and vision science that says that over-aggressive eyeglass prescription changes need to be avoided. Blurred vision contributes to the risk of falling in older adults—but getting new glasses with a big change in vision prescription may increase the risk rather than decreasing it. Falls are the major cause of accidental death and non-fatal injuries in the elderly. At least one-third of healthy adults age 65 or older fall at least once a year. For those 90 or older, the risk increases to about 60 percent.

The reviewer, David B. Elliott, PhD, says that falls in older adults aren't accidents. Most of the time, they're related to a wide range of risk factors including older age, disabilities, muscle weakness, and many different medical conditions. The more risk factors you have, the more likely you are to fall.

In the elderly, reduced vision in a large risk factor for falls. This suggests that interventions to correct vision, glasses, or cataract surgery, would reduce the risk of falling. The surprising factor, most studies have shown little or no reduction in falls among the elderly receiving a new vision correction.

Magnification from some new glasses may contribute to increased risk of falls. Receiving large changes in a glasses prescription also increases the risk of falls. This is because the frail elderly may have more difficulty adapting to these large changes and often are at increased risk of falling during the period of adapting.

I needed to smile when I read, 'If it ain't broke, don't fix it' when speaking about large or magnification changes in glasses for the elderly. The elderly take longer to adapt to changes in glasses prescriptions because they are not familiar with some changes. Dr. Elliott advises caution with changes for the elderly.

Maximizing vision corrections for the elderly is not advised and optometrists need to assess properly the risk factors, including history of falls, medical conditions, and medications used. Dr. Elliott advises taking a conservative approach to prescribing new glasses for older adults with a history of falls or risk factors for falling.

Finally, Dr. Elliott suggests keeping the same type of prescriptions, bifocals, or progressive lenses, unless there is a significant reason for change. If a patent is used to wearing single-vision glasses, they should not be moved to bifocals or progressive lenses. A change like this is going to increase the risk of falls.

If you are a caregiver for an elderly person, always be aware of what the person uses for glasses and if necessary, change optometrists if they are being radical in the changes in glasses.

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