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Association between self-reported visual symptoms (suggesting cataract) and self-reported fall-related injury among adults aged ≥ 65 years from five low- and middle-income countries



Cataracts may increase risk for falls but studies on this topic from low- and middle-income countries (LMICs) are scarce. Therefore, we examined the cross-sectional association between self-reported visual symptoms (suggesting cataract) and self-reported injurious falls in nationally representative samples of adults aged ≥ 65 years from five LMICs (China, Ghana, India, Mexico, and Russia).


Data from the WHO Study on global AGEing and adult health (SAGE) were analysed. Self-reported information on past 12-month fall-related injury and cataract based on symptoms were collected. Multivariable logistic regression and meta-analyses were conducted to assess associations.


Data on 13,101 people aged ≥ 65 years were analysed [mean (SD) age 72.5 (11.3) years; 45.2% males]. The overall prevalence of self-reported fall-related injury and visual symptoms (suggesting cataract) were 4.9% and 29.4%, respectively. There was a positive association between self-reported visual symptoms (suggesting cataract) and fall-related injury (i.e., OR > 1) in all five countries but statistical significance was reached in three: China (OR = 1.60; 95% CI = 1.08–2.35), India (OR = 1.96; 95% CI = 1.15–3.35), and Russia (OR = 3.58; 95% CI = 2.06–6.24). The pooled OR including all five countries based on a meta-analysis was OR = 1.88 (95% CI = 1.32–2.68).


Self-reported visual symptoms (suggesting cataract) were associated with higher odds for self-reported injurious falls among older adults in LMICs. Expanding availability of cataract surgery in LMICs may also have the additional benefit of reducing falls among older people.

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Fig. 1
Fig. 2: Country-wise association between self-reported visual symptoms (suggesting cataract) and fall-related injury (outcome) estimated by multivariable logistic regression.

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Data availability

The data that support the findings of this study are available from the corresponding authors upon reasonable request.


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This paper uses data from WHO’s Study on Global Ageing and Adult Health (SAGE). SAGE is supported by the U.S. National Institute on Aging through Interagency Agreements OGHA 04034785, YA1323–08-CN-0020, Y1-AG-1005–01 and through research grants R01-AG034479 and R21-AG034263.


Dr. Guillermo F. López Sánchez is funded by the European Union – Next Generation EU.

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Correspondence to Guillermo F. López Sánchez or Jae Il Shin.

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Smith, L., López Sánchez, G.F., Veronese, N. et al. Association between self-reported visual symptoms (suggesting cataract) and self-reported fall-related injury among adults aged ≥ 65 years from five low- and middle-income countries. Eye (2024).

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