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Aleksandra Mihailovic, Ayodeji Sotimehin, David S Friedman, Sheila K West, Pradeep Y Ramulu; Association of home hazards with the falls rates per time or per step in glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):1047.
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Individuals with the greater visual field loss from glaucoma are more likely to fall in and around their home, and in 40% of falls, they implicate environmental hazards as a reason behind the fall. In this analysis we evaluate whether home hazards are associated with the higher rate of falls, calculated as a rate over time or over steps taken.
In this 3-year prospective observational cohort study, participants were 57 years or older at recruitment, and had a diagnosis of primary glaucoma or were glaucoma suspects. Seven areas of participants’ home were evaluated (bedroom, bathroom, living room, kitchen, dining room, hallway and indoor stairs) for fall hazards using the Home Environment Assessment for Visually Impaired (HEAVI). Falls were reported over 36 months via mailed or emailed monthly calendars. Location and the circumstances around the falls were recorded over the phone through a questionnaire. Physical activity at home (number of home steps) for the duration of the study was estimated from yearly 7-day GPS and accelerometer trials. Analysis incorporated generalized estimating equation models to account for correlations of falls across rooms for the same individual.
One-hundred seventy participants were included in the analysis. Mean baseline age was 71.1 years and 46% were female. Average duration of the follow-up was 31.4 months (range: 7 to 36). Participants experienced a total of 87 falls inside of the home, and most falls occurred on the indoor stairs (28%) and in the bedroom (20%). Number of and frequency of hazards in the entire home or per room were not associated with either falls per year or falls per step (p>0.24). However, each 100 lux increment in room lighting was associated with 14% fewer falls/year (p=0.004) and 14% fewer falls/ home step taken (p=0.002).
Fewer home falls were noted with better lighting, but not with fewer number of hazards.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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