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Lisa Keay, Anusha Paritala, Rishabh Bhardwaj, Lisa Dillon, Bonnielin K Swenor, Vijaya Gothwal; Falls and vision loss in older people attending an urban tertiary eye centre in South India. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3357.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the relationship between vision and falls, fear of falling and physical performance in an older, urban clinical population in South India.
Outpatients aged 50 years and older from L V Prasad Eye Institute were invited to participate in a cross-sectional study. Falls in the past 12 months were self-reported, fear of falling assessed using the Short Falls Efficacy Scale-International (SFES-I, Rasch scored) and physical performance using the Short Physical Performance Battery (SPPB) overall score (0-12) and sub-scales: gait speed (ms-1), 5 times sit to stand (sec) and balance (0-40 sec). Falls, SFES-I and SPPB (and sub-scales) were modelled, to investigate the effect of high contrast visual acuity (VA) and Pelli-Robson contrast sensitivity (CS) in the better eye, adjusting for age, sex, comorbidities, cognition (Dementia Assessment by Rapid Test, 0-4) and medications.
A total of 140 patients were recruited: 86 male (61%), average 63 years with cataract (61, 44%), glaucoma (22, 16%), age-related macular degeneration (9, 6%), diabetic retinopathy (21, 15%) and other eye diseases (26, 19%). Better eye VA was 0.47±0.36 (mean±SD) logMAR, contrast sensitivity 1.17±1.97 and 69 (52%) wore glasses (93% bifocals, 7% single vision). A human guide was used by 13 (9%) and 2 (1%) used a support cane/walking stick. Comorbidities were reported in 100 participants (71%, average number was 1.8±0.8, maximum 4) and 21 (15%) scored ≥3 on the cognitive screening. Falls in the last year were reported by 13 (9%) and risk of a fall was 1.52x higher (95% CI 1.12-2.01) per line reduction in VA. The SFES-I fear of falling score was on average ‘somewhat concerned’ and patients had greater fear of falling with worse CS (p=0.0006) adjusting for older age (p=0.01), female sex (p=0.046) and worse cognition (p=0.01). Average SPPB was 8.5±1.6 lower scores with older age (p<0.0001). Only the balance sub-scale was related to vision, whereby worse CS (p=0.0008) was associated with poorer balance.
Poor vision was associated with poor balance, falls risk and fear of falling in an older Indian clinical population. Falls were not commonly reported but there were deficits in physical performance in this population. Standardised physical performance test scores were consistent with normative data for fallers and older people with mobility impairment.
This is a 2020 ARVO Annual Meeting abstract.
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