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S.M. Szabo, M.J. Potter, K. Khan, S.R. Lord, P.A. Janssen; A Prospective Study of the Fall Risk Profile of Elderly, Community–Dwelling Women With Exudative Age–Related Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2134.
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© ARVO (1962-2015); The Authors (2016-present)
To perform a falls risk profile assessment in elderly, community–dwelling women with exudative age–related macular degeneration (AMD).
This was a cohort study of 116 women over the age of 70 with exudative AMD, who were assessed for fall risk using Lord’s Physiologic Profile Assessment (PPA). The PPA generates a standardized fall risk profile compared with a control population, who were collected as part of the Randwick Falls and Fractures Study. The PPA risk profile describes participant vision (high and low contrast visual acuity (VA), and edge contrast sensitivity), reaction time, sway (eyes open and closed), proprioception and strength. Data on additional risk factors including age, time since diagnosis, medical comorbidities, bilateral status of disease, daily physical activity levels, and self–reported 12–month history of falls were collected by personal interview and from medical records. All participants were followed for twelve months, with monthly telephone follow up, to determine incidence of falls.
Average participant age was 81 years. Twenty–four participants reported a history of a fall in the previous year (20.7%) and nine (7.8%) gave a history of multiple falls. Fifty women (43%) had bilateral AMD at baseline. The mean time since diagnosis in the first eye was 26 months (range, 1–120 months). Eighty–one women (70%) reported walking at least three times a week, 34 women (29.3%) participated in sports or recreational activities at least once a week, and 45 woman (38.7%) reported participating in an exercise program at least once a week. The mean fall risk score for women with AMD, in standard deviations (SD) above the mean for 65–year old normal women, was 3.3, representing a markedy elevated risk for falling. Severe impairments (>1SD from the mean) were observed in the following elements of the PPA: high (–1.6 SD) and low (–2.4 SD) contrast VA, edge contrast sensitivity (–1.7), sway (open, –1.8; closed, –2.6), and reaction time (–1.6). Measures of strength (–0.4) and proprioception (–0.2) approached normal.
Based on a physiologic fall risk profile assessment, elderly women with AMD are at a high risk of falling compared with the normal population. Strategies to reduce fall risks will be important in this high risk group in order to prevent falls and injury.
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