Vision changes and PD: Aging and Fall Risk

Older people with PD may face a heightened risk for falls due to vision changes related to the disease and the aging process.

Falls are a significant risk for people with Parkinson’s disease. Studies show that between 45% and 68% of people with PD will fall each year, with a large proportion (50–86%) falling recurrently. Many risk factors for falls in PD have been identified including freezing of gait, slow gait and postural instability. Vision is especially important for people with PD to compensate (through visual guidance) for these and other movement problems caused by basal ganglia dysfunction.

Older adults also rely on vision to compensate for decreased balance and gait difficulties. A large-scale survey study found that visual acuity, contrast sensitivity, glare sensitivity, and visual field size were significantly correlated with fall risk in older adults. Eye diseases such as a cataracts and glaucoma were associated with falls.

The majority of visual functions — visual acuity, contrast sensitivity, glare sensitivity, and visual field size — have been found to decline linearly with age. Age-related vision changes are largely due to physical changes in the eye and slowing of visual perceptual processing.

People with PD are more likely to experience these same problems — decreased visual acuity (due to blurred vision or double vision), impaired contrast sensitivity function, and reduced visual field — because of changes in the eyeball, eye muscle function and visual perceptual processing related to disease progression.

How can you maintain your best vision to decrease the risk of falls?

• Get a regular eye health exam

• Consider referral to a neuro-ophthalmologist for specialized testing and prism lenses

• Increase the amount of ambient lighting in the rooms your home by using torch lamps with full spectrum light bulbs

• Enhance visibility of stair edges, steps or pathways by adding contrasting colored tape or paint

• Consult with an occupational therapist trained in home and lighting modifications for fall prevention