Visual perception dominance of fallers among community-dwelling older adults.

The authors postulated that older adult fallers show a greater tendency than older adult nonfallers to rely more on visual information sources in maintaining upright posture than on kinesthetic and vestibular cues. This paper presents descriptive statistics on 199 older adults living independently in the community. Their visual perception of the vertical and horizontal was analyzed with respect to age, sex, health status, and severity of injury as a result of a fall. The finding of significant impairments for fallers in visual perceptual abilities confirmed a trend previously established by one of the authors (Tobis). When the visual field entailed only misleading or ambiguous cues in the form of a tilted frame, fallers again showed a larger error than nonfallers in establishing the vertical and horizontal. The authors feel that this relatively greater dependence on visual sources may develop in response to impairment of feedback on posture and gait from the kinesthetic and vestibular systems as a result of age and chronic health problems. Errors in visual perception of the vertical and horizontal intercorrelated with age, sex, and a large number of medical problems. However, visual variables were more important in predicting faller status than physical characteristics.