Falls in Older People: Effects of Age and Blurring Vision on the Dynamics of Stepping

Abstract

Findings indicate, in general, that older subjects used a more cautious and controlled stepping strategy. However, the lack of significant age differences in toe clearance suggests this strategy was mainly aimed at reducing ML instability rather than increasing margins of safety regarding toe clearance.

Time to Refocus Assessment of Vision in Older Adults? Contrast Sensitivity but Not Visual Acuity Is Associated With Gait in Older Adults

“…The gait assessment task used in this study reflects straight line walking undertaken in conditions of high luminance, contrast and is free from hazards. The role of vision in this context is likely less critical than under more challenging conditions comprising obstacle avoidance and lower lighting which may account for small effect size detected here (12,32,33). In light of these results, a more comprehensive battery of visual tests should be considered including stereoacuity and visual field size (34).…”

Endothelial Cell Survival and Graft Profile Analysis in Descemet Stripping Endothelial Keratoplasty

“…The advantages of DSEK over PK include faster visual rehabilitation, 2,5,6 less induced astigmatism, 2,6 and reduction in complications associated with corneal sutures. 20 Furthermore, the structural integrity of the globe is retained, 5,8 which is especially pertinent because DSEK patients have an average age of 70 years, 5,21 are more likely to fall, 22 and therefore are at greater risk for globe rupture.…”

Effects of Illumination on Toe Clearance and Gait Parameters of Older Adults when Stepping over an Obstacle: a Pilot Study

“…The lack of an increase in toe clearance under low lighting conditions (particularly when sensory information was reduced) may be linked to age-related limitation in frontal plane pelvic motion and in the interplay of lower extremity energy patterns within the sagittal plane 21) . Alternatively, reduced toe clearance may also be related to the significant reduction in mediolateral (ML) center of mass (COM)-center of pressure (COP) separation determined for older adults, which results in reduction in sideways momentum of the body 22) . Without adequate sideways momentum of the body more energy would have been required to lift the swing leg sufficiently to clear the obstacle edge, because elevation of the swing leg occurs with a sideways tilting motion of the body 23) .…”

“…Older adults appeared to adopt a stability-oriented strategy to minimize the risk of ML instability by reducing toe clearance of the trailing leg. Such a strategy would require less time spent in single-leg support, thereby decreasing the period of greatest risk of instability 22) .…”

“…This suggests that older adults may have adopted a tripping avoidance strategy for the leading leg, rather than stability-oriented safety strategy, in order to minimize and ensure safety when crossing an obstacle 22) . However, in order to ensure the expected safety margin to avoid tripping in a low lighting environment, executing a larger toe clearance of the leading leg (10.62 cm ± 6.82 cm for the leading leg vs. 6.81 ± 4.92 cm for the trailing leg in the l lx condition) would have required greater time spent in single support, which would ultimately increase the period of instability 22) .…”