Abstract
Abstract: :
Purpose: To determine the impact of cataract surgery on mobility, balance and the occurrence of falls in the years following surgery, as compared to those older adults who have cataract but who do not elect surgery. Methods: A prospective study of 209 cataract patients seen in eye clinics, aged 55 to 84 years at enrollment; 122 of whom elected surgery and 87 did not. Information pertaining to the occurrence of self–reported falls as well as mobility and balance difficulty was collected at baseline and at subsequent follow–up visits. For those electing surgery, baseline and follow–up visits reflect pre– and post–surgery, respectively. Change in the frequency of falls, mobility and balance difficulty was compared within groups using McNemar’s test. Logistic regression was used to compare the impact of cataract surgery on these outcomes between groups. Results: There was no difference in the proportion of subjects reporting falls between baseline and follow–up neither for those who elected surgery (38.5% vs. 36.1%; p=0.69) nor those who did not (32.2% vs. 35.6%; p=0.63). For the surgery patients, the frequency of mobility problems was similar at baseline and follow–up (23.8% vs. 29.7%; p=0.26); however, for those not electing surgery the frequency of mobility problems was significantly larger at follow–up compared to baseline (24.1% vs. 40.2%; p<0.001). Similarly, for surgery patients the occurrence of balance problems was consistent between visits (15.5% vs. 18.9%; p=0.37) whereas a significant increase was observed for those who did not elect surgery (9.2% vs. 19.5%; p=0.02). With respect to changes between groups, the risk of falling during follow–up did not differ between the two groups (odds ratio [OR] 1.03, 95% confidence interval [CI] 0.56–1.96). Subjects not electing surgery had an increased risk of mobility problems (OR 1.89, 95% CI 0.98–3.70); yet the association was marginally statistically significant (p=0.06). A positive yet non–significant association was also observed for balance problems (OR 1.59, 95% CI 0.69–3.70). These associations were adjusted for differences in demographic, behavioral and medical characteristics between the groups. Conclusions: Cataract surgery appears to prevent an increase in the risk of mobility and balance problems but not falls.
Keywords: cataract • aging • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials