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Falls are one of the most common health concerns families face as parents age, and there’s rarely a single cause. Why do older adults fall? Muscle weakness, certain medications, and hazards around the home are the usual suspects. Vision belongs on that list too, and it’s often the one nobody thinks to check first.

Common Causes of Falls in Older Adults

Before looking specifically at vision, it helps to see the fuller picture. Falls in older adults are typically linked to a combination of factors:

• • Muscle weakness, especially in the legs, which affects balance and the ability to catch oneself

• • Medication side effects, including drowsiness, dizziness, or blood pressure changes from certain prescriptions

• • Balance and gait changes, related to inner ear issues, neurological conditions, or general deconditioning

• • Environmental hazards, like loose rugs, poor lighting, or cluttered walkways

These factors come up often in fall-prevention conversations. But vision is also significant, and far less commonly discussed.

Vision Loss: An Overlooked but Major Contributor

Vision impairment is far more common among older adults than most families realize. More than 1 in 4 U.S. adults age 71 and older have measurable vision impairment, according to a 2023 JAMA Ophthalmology study. It isn’t a footnote in fall risk, either. 

In fact, the CDC’s STEADI fall-prevention framework lists vision impairment as one of a short list of factors clinical teams are specifically trained to screen for, alongside gait, balance, and medication use.

But unfortunately, for many families, vision doesn’t come up in a fall-risk conversation until after a fall has already happened.

How Vision Conditions Affect Fall Risk

Several eye conditions become more common with age, and each affects fall risk differently.

• • Cataracts cause clouding of the eye’s lens, which reduces night vision and increases sensitivity to glare.

• • Glaucoma causes gradual, often symptomless loss of peripheral vision.

• • Macular degeneration affects central vision, so a person may navigate a hallway without difficulty but be unable to see what’s directly in front of them.

• • Diabetic retinopathy causes vision to fluctuate along with blood sugar levels.

• • Contrast sensitivity, the ability to distinguish an object from its background, also declines with age independent of any diagnosed eye disease, and it isn’t measured by a standard eye chart.

That last point matters. A parent can pass a basic vision test at the eye doctor and still have the exact deficit that’s raising their day-to-day fall risk.

Signs Your Loved One’s Vision May Be Increasing Their Fall Risk

Vision loss is usually gradual, and people adapt to it without realizing, memorizing a hallway or walking a familiar route by feel long before anyone notices a change. A few signs worth paying attention to:

• • Squinting or hesitating at doorways and thresholds

• • Reaching for walls or furniture instead of walking a clear path

• • Missed steps, especially in dim hallways or unfamiliar rooms

• • Reluctance to move around after dark or in low light

None of these prove a vision problem on their own, but together, they’re worth mentioning at the next eye doctor visit.

What Families Can Do

Whether you’re a professional caregiver or a family member helping a loved one at home, consistent habits make early detection possible.

At every visit, make a point to:

• • Inspect the skin, paying close attention to the heels, hips, tailbone, and any area that’s been under pressure

• • Help reposition your loved one in bed or in a chair regularly—small shifts in position relieve pressure on vulnerable areas

• • Keep the skin clean and dry

• • Notice how they’re moving and whether anything seems different from usual

• • Report changes promptly: redness, soreness, drainage, or any shift in comfort level

You don’t have to be certain something is wrong to make the call. If something doesn’t look right, that’s reason enough.

When Extra Support at Home Can Help

Regular in-home visits create more opportunities to notice what an annual eye exam can miss. A caregiver helping with daily routines is also in a position to notice squinting in bright light, hesitation at a doorway, or reaching for a wall instead of walking a clear path, and flag it early.

If you’re thinking through fall-proofing a parent’s home more broadly, read our blog about Preventing Falls in Seniors, which covers practical home safety steps beyond vision.

Concerned about a parent’s vision or fall risk? PurposeCare’s home care and home health teams can help with daily support and an extra set of eyes. Find care near you.