Yes / Background: Falls sustained when descending stairs are the leading cause of accidental death in older adults. Highly visible edge highlighters/friction strips (often set back from the tread edge) are sometimes used to improve stair safety, but there is no evidence for the usefulness of either. Objective: To determine whether an edge highlighter and its location relative to the tread edge affect foot placement/clearance and accidental foot contacts when descending stairs. Method: Sixteen older adults (mean ± 1 SD age; 71 ± 7 years) with normal vision (experiment 1) and eight young adults (mean ± 1 SD age; 24 ± 4 years) with visual impairment due to simulated age-related cataract (experiment 2) completed step descent trials during which a high contrast edge highlighter was either not present, placed flush with the tread edge, or set back from the edge by 10 mm or 30 mm. Foot placement/ clearance and the number of accidental foot contacts were compared across conditions. Results: In experiment 1, a highlighter set back by 30 mm led to a reduction in final foot placement (p b 0.001) and foot clearance (p b 0.001) compared to a highlighter placed flush with the tread edge, and the percentage of foot clearances that were less than 5 mm increased from 2% (abutting) to 17% (away30). In experiment 2, a highlighter placed flushwith the tread edge led to a decrease in within-subject variability in final foot placement (p = 0.004) and horizontal foot clearance (p = 0.022), a decrease in descent duration (p = 0.009), and a decrease in the number of low clearances (b5 mm, from 8% to 0%) and the number of accidental foot contacts (15% to 3%) when compared to a tread edge with no highlighter present. Conclusions: Changes to foot clearance parameters as a result of highlighter presence and position suggest that stairswith high-contrast edge highlighters positioned flushwith the tread edgewill improve safety on stairs, particularly for those with age-related visual impairment.

Yes / Purpose: Falls on stairs are a significant cause of morbidity and mortality in elderly people. A simple safety strategy to avoid tripping on stairs is increasing foot clearance. We determined whether a horizontal–vertical illusion superimposed onto stairs to create an illusory perceived increase in stair-riser height would increase stair ascent foot clearance in older participants. Methods.: Preliminary experiments determined the optimum parameters for the horizontal–vertical illusion. Fourteen older adults (mean age ± 1 SD, 68.5 ± 7.4 years) ascended a three-step staircase with the optimized version of the horizontal–vertical illusion (spatial frequency: 12 cycles per stair riser) positioned either on the bottom or top stair only, or on the bottom and top stair simultaneously. These were compared to a control condition, which had a plain stair riser with edge highlighters positioned flush with each stair-tread edge. Foot clearance and measures of postural stability were compared across conditions. Results.: The optimized illusion on the bottom and top stair led to a significant increase in foot clearance over the respective stair edge, compared to the control condition. There were no significant decreases in postural stability. Conclusions.: An optimized horizontal–vertical visual illusion led to significant increases in foot clearance in older adults when ascending a staircase, but the effects did not destabilize their postural stability. Inclusion of the horizontal–vertical illusion on raised surfaces (e.g., curbs) or the bottom and top stairs of staircases could improve stair ascent safety in older adults.