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H. Kergoat, T. Boutin, M.-J. Kergoat, J. Latour, F. Massoud; Vision in the Global Evaluation of the Frail Elderly Individual Hospitalized Following a Fall. Invest. Ophthalmol. Vis. Sci. 2010;51(13):3254.
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Falls are common in frail elderly individuals and may have dramatic consequences. They are associated with increased mortality, morbidity, functional loss and early institutionalization. The management of falls in short term geriatric assessment units (GAU) is interdisciplinary in nature and should include an evaluation of visual function. Our objective was to verify if vision is considered in the global evaluation of elderly individuals admitted in a GAU following a fall.
We reviewed the clinical charts of 80 elderly individuals (Mean ± SD: 82.3 ± 6.2 yrs) hospitalized in university based GAUs after a fall as well as 80 age- and sex-matched (81.4 ± 6.5 yrs) controls hospitalized within the same period of time but without a history of falls. All pertinent data were extracted from the clinical charts and entered in FileMaker Pro and Excel softwares for analysis.
Most falls were non-accidental (n= 74) and were multifactorial (n= 64). Cases were taking more anti-arythmic agents (p= 0.015) and antidepressants (p= 0.023) but less calcium channel blockers (p= 0.038) than controls. The medical history indicated that the cases were more likely to have cataracts (n= 19 vs 6; p= 0.004), age-related macular degeneration (n= 8 vs 2; p= 0.048) and decreased visual acuity (n= 26 vs 14; p= 0.025). The cases were referred more often than controls for an eye examination (n= 29 vs 14; p= 0.004).
Our results indicate that even though patients with a history of falls are referred more often than controls for an eye examination, their vision is not evaluated systematically despite the recommendations of the American and British Geriatric Societies. These data indicate that eye care professionals should work more closely with the medical team to improve the overall clinical care of elderly individuals with a history of falls.
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