September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Falls and cataract: investigating risk and predictors in older adults during their wait for surgery
Author Affiliations & Notes
  • Lisa J Keay
    The George Institute for Global Health, Sydney University, Missendon Road, New South Wales, Australia
  • Anna Palagyi
    The George Institute for Global Health, Sydney University, Missendon Road, New South Wales, Australia
  • Kris Rogers
    The George Institute for Global Health, Sydney University, Missendon Road, New South Wales, Australia
  • Lynn Meuleners
    Curtin-Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  • Peter J McCluskey
    Save Sight Institute, The University of Sydney, Sydney, New South Wales, Australia
  • Andrew JR White
    Westmead Institute, The University of Sydney, Sydney, New South Wales, Australia
  • Jonathon Ng
    School of Population Health, The University of Western Australia, Perth, Western Australia, Australia
  • Nigel Morlet
    Curtin-Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
  • Footnotes
    Commercial Relationships   Lisa Keay, None; Anna Palagyi, None; Kris Rogers, None; Lynn Meuleners, None; Peter McCluskey, None; Andrew White, None; Jonathon Ng, None; Nigel Morlet, None
  • Footnotes
    Support  Australian National Health and Medical Research Council Project Grant APP1048302
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Lisa J Keay, Anna Palagyi, Kris Rogers, Lynn Meuleners, Peter J McCluskey, Andrew JR White, Jonathon Ng, Nigel Morlet; Falls and cataract: investigating risk and predictors in older adults during their wait for surgery. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : There is strong evidence of increased falls risk associated with cataract. Although cataract surgery can restore sight, lengthy waiting times are common in many high income countries, including Australia. Here, we report the risk and determinants of falls in older people with cataract during their surgical wait.

Methods : Data from a prospective study of falls in a cohort of patients aged ≥ 65 years on Australian cataract surgery waiting lists were analysed. Participants underwent assessment of vision, comorbidity, physical activity and health-related quality of life (HRQoL), and recalled falls in the previous 12 months. Falls were also self-reported prospectively using monthly calendars; the context and outcomes of any falls were determined by interview.

Results : Of 329 participants, mean age was 76 years and 55% were female. Participants’ habitual vision was an average of 20/40 (20/16 to 20/160) and 10% were vision impaired (<20/60). Falling in the previous 12 months (129 [39%] participants) was associated with the use of antidepressant medication (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.7−7.5) and older age (OR1.3, 95%CI1.1−1.6; five year increase in age). A total of 242 falls were reported prospectively by 97/329 (30%) participants during the surgical wait – a falls rate of 1.2 per year. Poorer patient reported visual disability (incidence rate ratio [IRR] 1.1, 95%CI1.0−1.2), lower self-rated HRQoL (IRR1.1, 95%CI1.0−1.2), increased walking activity (IRR1.1, 95%CI1.0−1.1), lower BMI (IRR1.1, 95%CI1.0−1.1) and a history of falls (IRR2.5, 95%CI1.6-4.0) were predictive of falls risk. Over one half (51%) of falls were injurious, including 11 head injuries and 2 fractures.

Conclusions : These findings provide insight into associations with increased falls risk in older adults with cataract. We demonstrate the negative impact of impaired vision function on falls risk and injury, and reinforce the need for improved efficiency of surgical services to avoid escalation of this critical public health issue.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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