ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .
Higher risk of multiple falls among elderly women who lose visual acuity.
OBJECTIVE To determine the association between changes in visual acuity ( VA ) and  frequent falls in older women . DESIGN Prospect i ve cohort study . PARTICIPANTS Two thous and two elderly community-residing women participating in the Study of Osteoporotic Fractures with measurements of VA at baseline and a follow-up examination 4 to 6 years later ( mean of 5.6 years ) . METHODS Binocular VA with habitual correction was measured under st and ard illumination using Bailey-Lovie charts at baseline and fourth examinations . Change in VA was stratified into 5 categories : no change or VA gain , loss of 1 to 5 letters , loss of 6 to 10 letters , loss of 11 to 15 letters , and loss of > 15 letters . A separate analysis considered decline in VA as the loss of > or=10 letters ( > or=2 lines ) on the Bailey-Lovie acuity measure between baseline and follow-up examinations . MAIN OUTCOME MEASURES Data on falls were obtained from postcards sent every 4 months after the follow-up examination . Frequent falling was defined as > or=2 falls during a 1-year period after the follow-up examination . RESULTS Compared with women with stable or improved VA , women with declining acuity had significantly greater odds of experiencing frequent falling during the subsequent year . Odds ratios after adjustment for baseline acuity and other confounders were 2.08 ( 95 % confidence interval [ CI ] : 1.39 - 3.12 ) for loss of 1 to 5 letters , 1.85 ( 95 % CI : 1.16 - 2.95 ) for loss of 6 to 10 letters , 2.51 ( 95 % CI : 1.39 - 4.52 ) for loss of 11 to 15 letters , and 2.08 ( 95 % CI : 1.01 - 4.30 ) for loss of > 15 letters . In the analysis of visual decline defined as a loss of > or=10 letters , heightened risk of frequent falling was evident in each of 2 subgroups defined by splitting the sample on baseline VA , with borderline significant evidence of a more pronounced effect in those women with baseline VA of 20/40 or worse ( P value for interaction , 0.083 ) . CONCLUSIONS Loss of vision among elderly women increases the risk of frequent falls . Prevention or correction of visual loss may help reduce the number of future falls
ORs were generally higher for recurrent fallers than for all fallers .
This meta- analysis provides comprehensive evidence -based assessment of risk factors for falls in older people , confirming their multifactorial etiology .
Some nonspecific indicators of high baseline risk were also strong predictors of the risk of falling
BACKGROUND Falls are the main cause of accidental death in persons aged 65 years or older .