# Assessing the Interplay of Vision with Cognitive Functioning, Balance, and Falls in Middle-aged Women

> **NIH NIH R21** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2020 · $234,000

## Abstract

Abstract
Evidence is catching up with common knowledge that vision impairment (VI) plays a role in balance, falls and
cognitive impairment. These conditions are serious public health issues because of their impact on
independence, both fatal and nonfatal injuries, and secondary consequences on social networks and the
economy. Among US adults older than 65 years in the 2014 Behavioral Risk Factor Surveillance System
survey, 29% reported a fall in the past year with estimates of 29 million falls resulting in 7 million injuries, 2.8
million emergency visits, 800,000 hospitalizations, and 27,000 deaths. A 2017 cross-sectional study of two
datasets (National Health and Nutrition Examination Survey and National Health and Aging Trends Study) of
nearly 33,000 older Americans showed that poor vision was associated with poor cognition. There is a
knowledge gap in understanding the relationships among vision, physical function, balance, falls, and
cognitive function. Because of this gap, a critical barrier exists for clinicians who care for older adults in
recognizing preventive and treatable factors that are linked to cognitive decline and falls to assure healthy
aging. Our goal is to understand the causal role of VI on fall outcomes with mediators of physical function,
balance, and cognitive function. Our hypothesis is that specific measures of visual function (e.g., contrast
sensitivity) are associated with age-related outcomes of physical function, balance, falls, and cognitive
function. We will test this hypothesis in the Michigan cohort (N=543; baseline mean age of 51 ± 4.2 years,
60% Black, 40% White) of the Study of Women's Health Across the Nation (SWAN). This is an ongoing, 20-
year, longitudinal study of women during mid-life and aging. Longitudinal data are available for vision, physical
function, balance, falls, environmental and biological factors, and cognitive function. During the most recent
visit (V16), our team conducted extensive eye exams and tests on 255 women (age 66 ± 2.7 years; 62% black
and 38% white). This dataset provides a unique, cost-effective opportunity to address the knowledge gap by
analyzing relationships among vision, physical function, balance, falls, and cognitive function. We will test the
hypothesis in two aims. Aim 1: Test the hypothesis that visual impairment (VI) is associated with
physical function, balance and falls, and evaluate the role of physical function and balance as
mediators of the effect of VI on falls. Aim 2: Test the hypothesis that visual impairment is associated
with cognitive function, and evaluate the role of cognitive function as a mediator of the effect of visual
impairment on falls. By addressing these aims, we will advance understanding of the interplay of vision,
physical function, balance, falls, and cognitive function. By doing so, all clinicians who care for older adults will
be equipped to identify treatable and preventive factors that are linked to falls and cognitive decline, and
ther...

## Key facts

- **NIH application ID:** 9892014
- **Project number:** 5R21EY030363-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** DAVID C MUSCH
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $234,000
- **Award type:** 5
- **Project period:** 2019-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9892014

## Citation

> US National Institutes of Health, RePORTER application 9892014, Assessing the Interplay of Vision with Cognitive Functioning, Balance, and Falls in Middle-aged Women (5R21EY030363-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9892014. Licensed CC0.

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