May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Impaired vision as an independent risk factor for falls and fractures
Author Affiliations & Notes
  • M.R. de Boer
    Department of Ophthalmology,
    VU University Medical Center, Amsterdam, The Netherlands
  • S.M. F. Pluijm
    Institute of Research in Extramural Medicine (EMGO Institute),
    VU University Medical Center, Amsterdam, The Netherlands
  • D.J. H. Deeg
    Institute of Research in Extramural Medicine (EMGO Institute),
    Department of Psychiatry,
    VU University Medical Center, Amsterdam, The Netherlands
  • H.J. Völker–Dieben
    Department of Ophthalmology,
    VU University Medical Center, Amsterdam, The Netherlands
  • A.C. Moll
    Department of Ophthalmology,
    VU University Medical Center, Amsterdam, The Netherlands
  • P. Lips
    Institute of Research in Extramural Medicine (EMGO Institute),
    Department of Endicrinology,
    VU University Medical Center, Amsterdam, The Netherlands
  • G.H. M. B. van Rens
    Department of Ophthalmology,
    VU University Medical Center, Amsterdam, The Netherlands
    Department of Ophthalmology, Elkerliek Hospital, Helmond / Deurne, The Netherlands
  • Footnotes
    Commercial Relationships  M.R. de Boer, None; S.M.F. Pluijm, None; D.J.H. Deeg, None; H.J. Völker–Dieben, None; A.C. Moll, None; P. Lips, None; G.H.M.B. van Rens, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 1377. doi:
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      M.R. de Boer, S.M. F. Pluijm, D.J. H. Deeg, H.J. Völker–Dieben, A.C. Moll, P. Lips, G.H. M. B. van Rens; Impaired vision as an independent risk factor for falls and fractures . Invest. Ophthalmol. Vis. Sci. 2004;45(13):1377.

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

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Abstract

Abstract: : Purpose:To examine whether impairments in near contrast sensitivity and other aspects of vision are associated with falls and fractures in a prospective multi factorial design. Methods:Study population A random sample of older men and women, was drawn from the population registers of 11 municipalities in the Netherlands. During three years, participants were asked to record fall events and fractures every week on a ‘fall–and fracture calendar’ and to mail the calendar page to the institute at the end of every three–months. In addition, information on fractures was collected retrospectively at the end of the three year follow–up. Contrast sensitivity was measured using the VCTS_6000–1 chart for near vision (Vistech Consultants Inc.). We have calculated the integrated contrast sensitivity (ICS) for each eye separately. The ICS represents the total amount of visual information that is assimilated by the visual system and equals the surface under the contrast sensitivity curve when plotted on a linear scale. The ICS was dichotomized at the fifth percentile. Vision was also assessed by questions on reading the small print in a newspaper and recognizing someone's face at a distance of 4 meter. Finally, the participants were asked three questions on glare.Age and gender were considered potential effect modifiers in the relationship between vision and falling and vision and fractures. Besides age and gender, diabetes mellitus, osteoarthritis, cognition and depression, level of education, current smoking and use of corticosteroids were considered potential confounders. Results: After adjustment for age and depression, there were two statistically significant associations for recurrent falling. Low–frequency contrast sensitivity (combined score for 1.5 and 3 c/d) showed an elevated hazard ratio (HR) of 1.66 (CI 1.11–2.48), the ICS showed a HR of 1.53 (CI 1.03–2.29). There was a strong association between recognizing–faces and fractures in the adjusted analyses (HR = 3.10 ; BI 1,65–5.82). For the other vision variables, no statistically significant elevated hazard ratios could be observed. Conclusions: In this study contrast sensitivity and subjectively reported visual disability were shown to be associated with incident falls and fractures respectively.

Keywords: clinical (human) or epidemiologic studies: risk factor assessment • aging • contrast sensitivity 
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