Background Although vision impairment increases risk of falls, older people with vision impairment tend to be less active. The relationship between activity and falls is unclear.

Objective To investigate the rate of falls for older people with vision impairment living in the community and to explore the relationship between falls and levels of activity.

Methods Participants were aged 50+ years and registered with a community-based organisation providing orientation and mobility support services. Participants reported the number of falls in the last year and underwent field-based vision assessments. Weight and height were used to calculate body mass index (BMI). Physical activity was measured for one week using a wrist-worn accelerometer (Actigraph wGT3X-BT) and processed with a low activity filter, to estimate average daily steps. A Loess regression was used to explore the relationship between falls, falls per steps taken and total steps. Findings: Average age was 74 years (range 50–94 years), 57% (120/212) were female, 84% (178/212) were legally blind, BMI was 29.6±16.0 kg/m², 60% (127/212) reported falling in the past year and 33% (72/212) had multiple falls. The average annual number of falls was 1.9±3.2 and this rate was similar across different levels of activity. There was a negative relationship between falls per steps taken and total steps. The falls rate was 5.8 falls/10 million annual steps for participants with the lowest activity levels and 0.3 falls/10 million annual steps for participants with the highest levels of activity.

Conclusion This study confirmed the high rate of falls in this population. Those with the highest risk were also the least active, taking the lowest number of steps.

Policy implications Measuring activity provides further insights into the mechanisms behind falls risk in high risk populations, such as older people with severe vision impairment.