September is Healthy Aging Month


Older adults need support and services to thrive and age with dignity. In 2020, there were 55.7 million adults 65 years and older in the U.S. Ambulatory (i.e., walking or climbing stairs) and vision support accounted for 39% and 21% of difficulties, respectively, among this age group. The risk of eye disease increases with age, yet many older adults neglect to see an eye care provider.

Dr. Lisa A. Hark, the Principal Investigator of NYC-SIGHT at Columbia University funded by the Vision Health Initiative at the Centers for Disease Control and Prevention (CDC), discusses falls risk among older adults with vision impairment in her program and the eye care that it provides.

lisa hark

How are you reaching older adults in your SIGHT study?

We have partnered with New York City Housing Authority and New York City Department for the Aging and are providing eye health screenings and exams in community and senior centers that are close to where people in affordable housing live to improve their access to eye care. We are targeting seniors who are at higher risk for glaucoma and other eye diseases because of their advanced age. Our study aims to improve early detection of glaucoma and visual impairment in underserved populations.

What kind of eye care services does your study provide to your participants?

We provide all participants with an initial eye health screening to assess visual acuity, intraocular pressure (IOP), and fundus photography images. Participants who fail this assessment are scheduled to see an on-site optometrist or referred to ophthalmology for follow up. As part of our randomized study trial, one group of participants that fails the assessment, receives complimentary eyeglasses and enhanced support from our staff to follow up with eye care with the ophthalmologist. The other group that fails screening and needs vision correction is given an eyeglass prescription only and a list of optical shops. All participants referred to ophthalmology are assisted in making their initial eye exam appointment.

A participant testing visual acuity.

Why is the risk of falls important for your SIGHT study?

Falls are one of the most common leading causes of unintentional injury and death. Falls-related deaths are highest among people with visual impairment and adults aged over 50. With age, there is deterioration in physical, visual, and cognitive functions. People with poor vision can easily lose stability and slip, trip, or fall. Therefore, older people with visual impairment should be the main targets of fall risk assessment.

How did you assess if your study participants are at risk for falls?

When we check their vision, we also use CDC’s Stopping Elderly Accidents, Death, and Injury or STEADI Tool Kit to assess for falls risk. We ask if they worry about falling; if they had any falls in the past year; if they visited the Emergency Department due to falling in the past year; and if they were admitted to the hospital after falling.

What has your study found about those at risk of falls and vision difficulties?

We have found that nearly half of our study participants either had a fall in the past year, felt unsteady when standing or walking, or worried about falling. We also found higher rates of self-reported dry eye, blurry vision, diabetic retinopathy, and cataracts among these participants.

What are the implications of your study for older adults?

Falls can affect quality of life in older adults, sometimes making it harder for them to safely live independently, age in place, and participate in activities in the community. However, falls are preventable, and older adults should get their eyes tested at least once a year by an eye care provider.

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