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Sagar Chapagain, Aleksandra Mihailovic, David S Friedman, Sheila K West, Pradeep Y Ramulu; Fall-related change in fear of falling and physical activity in persons with glaucoma. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4261. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Individuals with glaucoma are more likely to experience a fall than those normally sighted. Falls may lead to secondary effects, including increased fear of falling and physical activity restriction. Here, we assessed change in fear of falling or physical activity over a one-year period in glaucoma patients who fell vs. those who did not fall over this period.
Participants recruited into the study had primary glaucoma or were a glaucoma suspect. Falls data was collected prospectively, and those who experienced a fall over the first 12 months were classified as fallers. Annual one-week accelerometer trials were used to estimate average daily steps. Fear of falling was evaluated annually using a previously validated questionnaire, and responses were Rasch analyzed to produce a fear of falling score. The differences in the average daily steps or fear of falling score between the baseline and the first year of follow up were calculated and evaluated as the outcome measures in the multiple linear regression models.
Data from 226 participants was used in this analysis. Mean age was 70.4 years, 48% were female and 27% were African American. Forty-six percent of the participants had at least one fall in the 12 months of the follow up. Average number of the steps per day for fallers at the baseline and at the first year follow up was 4,041 (standard deviation (SD)=2,441) and 3,740 (SD=2,268) and among non-fallers 3,976 (SD=2,679) and 3,819 (SD=2,663), respectively. The average difference in the physical activity between the first year follow up and the baseline was -309 steps/day (SD=1,934) for fallers and -177 steps/day (SD=2,179) for non-fallers (β=-132 steps/day, 95% confidence interval [CI]=-711.2 to 451.2, p=0.66). Fallers compared to non-fallers demonstrated a significantly greater increase in fear of falling (0.50 logits more of change, 95%CI=0.06 to 0.94, p=0.026) at the first year follow up compared to baseline.
Glaucoma patients who experienced a fall within first 12 months of study follow up were more fearful of falling, but did not restrict their physical activity compared to non-fallers. Fear of falling has a significant psychological impact on individuals, thus identifying those with the fear of falling and developing the interventions to reduce it may have significant impact on patients’ quality of life.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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