Manhattan Vision Screening and Follow-up Study (NYC-SIGHT) Cluster-Randomized Clinical Trial: Subanalysis of Falls Risk

Abstract

Purpose : Subanalysis conducted to assess falls risk among participants enrolled in the Manhattan Vision Screening and Follow-up Study using the Stopping Elderly Accidents, Death, and Injury (STEADI) Falls Risk Tool Kit developed by the US Centers for Disease Control and Prevention.

Methods : A 5-year prospective, cluster-randomized clinical trial conducted in affordable housing buildings and senior centers in New York City. Pre-screening questions determined whether participants were at risk of falling: 1) Do you feel unsteady when standing or walking? 2) Do you worry about falling? 3) Have you fallen in the past year? If you have fallen, were you injured? Those at risk were asked to complete the following STEADI tests during the eye health screening: 30-Second Chair Stand, Timed-Get-Up-and-Go, and 4-Stage Balance test (Fig. 1a, 1b, 1c). Participants were classified as low, moderate, or high-risk of falling. Multivariate logistic regression analysis determined the factors associated with a higher odds of falls risk.

Results : A total of 708 participants completed the eye health screening; 351 (49.6%) were invited to perform the STEADI tests during the eye health screening. Mean age of STEADI participants: 71.0 years (SD ±11.3); 72.1% female; 53.6% African American, 37.6% Hispanic. Level of falls risk: 32 (9.1%) low, 188 (53.6%) moderate, and 131 (37.3%) high. Individuals age >80 [OR=5.9206, 95% CI=(2.3832 to 14.7084), p=0.000], had blurry vision [OR=1.9781, 95% CI=(1.1858 to 3.2997), p=0.009], high blood pressure [OR=2.1314, 95% CI=(1.2521 to 3.6283), p=0.005], arthritis [OR=2.2976, 95% CI=(1.3624 to 3.8750), p=0.002], or foot problems [OR =5.2390, 95% CI=(2.9470 to 9.3139), p=0.000] had significantly higher odds of falling, emergency room visits or hospitalization due to falling.

Conclusions : This community-based eye health screening study detected a significant amount of falls risk in an underserved population. The STEADI Falls Risk screening questions are highly predictive of falls risk and may be adequate for referral to occupational health and/or physical therapy. Increased awareness of falls risk is needed by eye care providers due to the link between falling and vision impairment.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

FIGURE 1: STEADI Falls Risk Assessment
1a. 30-Second Chair Stand, 1b. Timed-Get-Up and Go, 1c. 4-Stage Balance Test