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Thomas Hong, Paul Mitchell, George Burlutsky, Chameen Samarawickrama, Jie Jin Wang; Visual Impairment and the Incidence of Falls and Fractures Among Older People: Longitudinal Findings From the Blue Mountains Eye Study. Invest. Ophthalmol. Vis. Sci. 2014;55(11):7589-7593. doi: https://doi.org/10.1167/iovs.14-14262.
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© ARVO (1962-2015); The Authors (2016-present)
We assessed the impact of visual impairment on the incidence of falls and fractures in older persons.
Of 3654 baseline participants, 2334, 1952, and 1149 were re-examined after 5, 10, and 15 years. Presenting visual acuity (VA) was measured at each examination. Bilateral and unilateral visual impairment was defined as VA worse than 20/40 in the better and worse eye, respectively. Incident visual impairment was defined in eyes with VA 20/40 or better at baseline, which subsequently developed visual impairment. Incidence of falls was assessed over the 12 months before each visit, whereas incidence of fractures was assessed over the 5 years between two visits. Discrete logistic-regression models with time-dependent variables were used to assess associations between visual impairment and subsequent falls and fractures after adjusting for potential confounding variables.
The proportions of participants reporting ≥2 falls ranged between 10% and 14%, and proportions reporting fractures ranged between 12% and 21%, across the three follow-up visits. Participants with incident visual impairment were more likely to report ≥2 falls in 5 years, OR (odds ratio) 1.46, 95% confidence interval (CI) 1.04 to 2.04 (bilateral), and OR 1.22, 95% CI 0.98 to 1.51 (unilateral). Compared to participants with normal vision, those with incident unilateral visual impairment had a higher incidence of fractures over 5 years (OR, 1.27; 95% CI, 0.98–1.51). No increased incidence of falls or fractures was evident after 5+ years among participants with visual impairment.
In this older cohort, recent development of visual impairment was associated with increased likelihood of subsequent falls and fractures in the next 5 years, independent of other confounding variables.
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