Presence of lower limb joint arthritis moderates the interrelationship between vision impairment and fear of falling avoidance behavior in older adults

Falling is a common concern for older adults. Previous studies showed that mobility performance is significantly lower in those with age-related eye diseases or lower limb arthritis, contributing to their increased fall risk. However, it is currently unknown how the co-presence of these 2 age-related sensorimotor impairments interacts to affect fear of falling (FOF) and associated activity-avoidance behaviors. A total of 200 participants recruited from an outpatient regional medical center (127 women, 73 men, age = 65.5 ± 8.4 years) participated in this study. The presence of age-related, uncorrected eye diseases (i.e., cataracts, glaucoma, retinopathy, and macular degeneration) and arthritis in the lower limb joints were recorded. Geriatric Fear of Falling Measure, Fear of Falling Avoidance Behavior Questionnaire, and Timed Up-and-Go test were used to assess FOF, avoidance behavior, and physical mobility, respectively. Moderated mediation analyses, corrected for age and body mass index, were performed. With the Geriatric Fear of Falling Measure as mediator, lower limb arthritis significantly moderated the indirect effects of eye disease on Timed Up-and-Go test performance (B = 1.00; 95% confidence interval = 0.06-2.11) and the Fear of Falling Avoidance Behavior Questionnaire score (B = 5.68; 95% confidence interval = 0.36-11.11). Namely, participants with uncorrected age-related eye disease and lower limb arthritis exhibited significantly poorer mobility and greater avoidance behavior than those without arthritis. The presence of age-related eye diseases exacerbates FOF avoidance behavior and leads to diminished mobility in older adults. The severity of FOF is moderated by the presence of lower limb arthritis. These findings suggest that effective fall prevention strategies for older adults should incorporate comprehensive vision, musculoskeletal, and behavioral evaluations.