The role of impaired vision and declined cognition in falls and fall-related risk factors among older people receiving home care in Finland—a cross-sectional register study

The risk of vision impairment and cognitive decline increases with age and can jeopardize safe ageing at home. Our aim was to investigate the association of impaired vision and cognitive decline with falls among older adults receiving home care. Additionally, we examined how previously identified fall-related risk factors are linked to vision impairment and cognitive decline. We used register data (n = 26 353) from the Finnish Resident Assessment Instrument (RAI) database. Four groups were created based on vision and cognition status: 1) no vision impairment or cognitive decline, 2) vision impairment alone, 3) cognitive decline alone, and 4) co-occurring vision impairment and cognitive decline. Multinomial logistic regression was used to examine the association of impaired vision and cognitive decline with falls. Based on results among older adults receiving home care, 12% had vision impairment alone, 37% had cognitive decline alone, and 18% had co-occurring vision impairment and cognitive decline. Vision impairment and cognitive decline, both individually and when co-occurring, were associated with experienced falls. Previously identified fall-related risk factors appeared to accumulate especially for older adults with co-occurring vision impairment and cognitive decline. Our study showed that vision impairment and cognitive decline play a significant role in the ability to live safely at home, particularly when they co-occur. Special attention should be paid to this vulnerable group to ensure safe and independent ageing in place. Timely identification and management of vision impairment may be crucial in preventing co-occurring vision impairment and cognitive decline.