Abstract
Purpose :
To investigate if neighborhood factors are associated with fear of falling in older adults with mild, moderate, or severe visual field deficits due to glaucoma.
Methods :
Patients with visual field deficits due to glaucoma or suspected glaucoma were assessed for fear of falling. Fear of falling (FoF) was assessed using the University of Illinois at Chicago FoF Questionnaire, with lower Rasch-analyzed FoF composite scores indicating less fear. Census tract data were used to acquire neighborhood factors including Area Deprivation Index (ADI), racial and ethnic minorities share, college graduate share, poverty share, public parks access, job density and overall crime rate per 100,000 people, stratified by low (<2,500) and medium to high (>=2,500). Integrated visual field (IVF) sensitivity was used to stratify patients into mild, moderate, or severe VF loss due to glaucoma. Linear regression models were used to investigate the effect of neighborhood factors on FoF within the whole study sample and as stratified by severity of IVF damage. Additional models evaluated interactions between each neighborhood factor and severity of VF damage.
Results :
Average age of the 245 participants was 71, around half (49%) were female, and a third (29%) were Black. FoF did not increase significantly with racial and ethnic minority share, college graduate share, public park access, or job density. Furthermore, FoF did not increase significantly in areas with intermediate and high crimes rates when compared to areas with mild crime rates. FoF increased with a higher neighborhood poverty share among those with moderate IVF damage (β=0.83 logits per 10% increase in poverty share, 95%CI: 0.19-1.47, p=0.01). However, interaction terms between each neighborhood factor and IVF damage severity did not show disproportionate impact of the neighborhood factor on fear of fall among those with greater IVF damage.
Conclusions :
Some neighborhood factors seem to be associated with fear of falling among patients with glaucoma; however, our analysis does not demonstrate that neighborhood factors affect fear of falling more in those with greater glaucoma severity. Further research with, perhaps, longer observation period, is needed to thoroughly investigate this relationship.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.