Purchase this article with an account.
Victoria L Tseng, Anne L Coleman, Fei Yu, Jane A Cauley, Wenjun Li, Fridtjof Thomas, Rowan Chlebowski; The association between cataract surgery and falls in the Women’s Health Initiative. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2124.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To determine the association between cataract surgery and frequency of falls for participants of the Women’s Health Initiative (WHI) with a diagnosis of cataract.
Participants of the WHI with cataract were identified by linking WHI files with diagnosis and procedure codes from the Medicare database. Those with cataract surgery were followed from the date of surgery, while those without surgery were followed from the date of cataract diagnosis. Baseline characteristics that were examined included demographics, socioeconomic status, WHI study group, Charlson Comorbidity Index (CCI) score, hypoglycemic use, physical activity, prior fall frequency, cataract severity, and ocular comorbidities. Women who reported a new fall at ≥50% of follow-up visits within one or two years after cataract surgery or diagnosis were considered to have high fall frequency. Logistic regression analyses were performed to assess the associations between cataract surgery and one and two-year high fall frequency, while adjusting for all baseline characteristics.
From WHI study initiation in 1993 until 2013, there were 93,348 women with cataract, of whom 50,421 (54.0%) had cataract surgery. There were 3,069 (3.3%) women with high fall frequency within one year and 1,109 (1.2%) women with high fall frequency within two years. When comparing women with and without cataract surgery, the adjusted odds ratios (ORs) and 95% confidence intervals were 0.98 (0.81, 1.02) and 0.87 (0.74, 1.02) for high fall frequency within one and two years, respectively. There was a significant age*cataract surgery interaction (p<0.0001); adjusted ORs were 1.04 (0.88, 1.22), 0.84 (0.72, 0.98), 0.59 (0.47, 0.74), 0.64 (0.39, 1.06) for high fall frequency within one year and 1.11 (0.85, 1.45), 0.55 (0.42, 0.71), 0.47 (0.33, 0.67), 0.66 (0.29, 1.51) for high fall frequency within two years for women 65-69, 70-74, 75-79, and ≥80 years old, respectively. There were no statistically significant interactions within cataract severity and CCI strata.
For WHI participants with cataract, cataract surgery may be associated with reduced odds of one and two-year high fall frequency, especially for women 70 to 80 years old. This suggests that visual impairment may contribute to fall risk in elderly women, and that cataract surgery is a potentially effective intervention.
This PDF is available to Subscribers Only