Abstract
Purpose :
Identifying environmental risk factors is important to prevent falls in elderly with visual impairment. We examined the relationship between weather and seasons on falls and physical activity in a prospective cohort of older patients with visual field (VF) loss.
Methods :
Older patients with glaucoma were recruited from the Wilmer Eye Institute to participate in a three-year longitudinal study. Monocular VF results were combined to generate integrated VF sensitivity for each patient. Participants recorded the occurrences of falls and injurious falls using a monthly calendar over the three-year period. Steps and active minutes were recorded for 7 days consecutively at baseline and in each study year using an accelerometer. Average daily temperature and precipitation data were merged with corresponding study dates (National Centers for Environmental Information). Study dates were assigned to Northern Hemisphere astronomical seasons. Using multivariable logistic and negative binomial regression models incorporating generalized estimating equations, we analyzed the association between weather/season with 1) the odds of falling and having an injurious fall and 2) average daily steps and active minutes.
Results :
Across 240 participants (Table 1), there were 406 falls recorded over 7569 person-months, of which 163 were injurious (40%). The odds of falling did not vary with temperature, precipitation, or seasons. However, every ten-degree Celsius increase in average daily temperature was associated with 24% higher odds of having an injurious fall, as opposed to non-injurious (OR=1.24, 95% CI [1.01, 1.53], p=0.04). Injuries resulting from a fall were more likely to occur outdoors, as opposed to indoors, with higher average temperatures (OR per 10 degrees C=1.46, 95% CI [1.03, 2.07], p=0.03) and summer season (OR=2.69 vs winter, 95% CI [1.12, 6.50], p=0.03). Temperature, precipitation, and seasons were not significantly associated with average daily steps or activity (Table 2).
Conclusions :
Although overall falls and physical activity did not vary with weather or seasons, warmer weather may be linked with conditions that lead to injurious falls among older individuals with visual impairment. Falls should be understood as a year-round problem in the visually impaired, though the likelihood of injury and the location of fall-related injuries may change with season/temperature.
This is a 2021 ARVO Annual Meeting abstract.