Vision, Footwear and Medication: Hidden Fall Risk Factors
When we think about fall risk, we typically focus on strength, balance, and home hazards. But three additional factors — vision, footwear, and medications — are equally important and often overlooked. Addressing these can significantly reduce fall risk with relatively simple interventions.
Vision is fundamental to balance. We rely on visual input for approximately seventy per cent of our balance information. Vision changes that affect fall risk include: reduced visual acuity (blurry vision), reduced contrast sensitivity (difficulty seeing edges, particularly in poor lighting), reduced depth perception (difficulty judging distances, particularly on stairs), and peripheral field loss (not seeing obstacles to the side). Regular eye examinations, updating glasses prescriptions, and ensuring adequate lighting (particularly on stairs and at night) are essential. Cataracts, which reduce contrast sensitivity, are a common and treatable contributor to falls.
Footwear is the only point of contact between the body and the ground, making it critical for balance and stability. Good footwear for fall prevention has: a firm, non-slip sole, a low, broad heel, good support around the ankle, a secure fastening (laces or velcro), and adequate room for the toes. Walking in socks, slippers without backs, or worn-out shoes significantly increases fall risk. Common foot problems — bunions, calluses, long toenails, and deformities — also affect balance and should be addressed by a podiatrist.
Medications are perhaps the most underappreciated fall risk factor. Several categories of medication increase fall risk: sedatives and sleeping tablets (reducing alertness and reaction time), blood pressure medications (causing dizziness on standing), antidepressants, antipsychotics, and some pain medications. The risk increases with the number of medications — taking four or more medications (polypharmacy) is itself a risk factor. A medication review with your GP or pharmacist can identify medications contributing to fall risk, and alternatives or dose adjustments may be possible.
Our falls prevention service addresses all these factors as part of a comprehensive falls risk assessment. Combined with our elderly physiotherapy service, we provide a holistic approach to fall prevention that addresses every contributing factor.