Abstract
Purpose :
Previous investigations suggest that falls are a leading cause of mortality among older people, and those with either diabetic retinopathy (DR) or vision impairment (VI) have an increased risk of falls. However, to our knowledge, there has been no analysis of the effects of both VI and DR on falls. We performed a cross-sectional analysis of the Behavioral Risk Factor Surveillance System (BRFSS) to investigate VI and DR and their correlation with falls.
Methods :
A cross-sectional analysis of the 2018 BRFSS included 4170 individuals, who were ≥40 years in the United States. Data were divided into groups based on self-reported DR and VI status: those without VI or DR, those with DR only, those with VI only, and those with both VI and DR. Sociodemographic and chronic health conditions were included in our analysis. Significance (p<0.05) was assessed using chi-square and ANOVA tests, and incidence rate ratios were also determined.
Results :
Among all four study groups (No VI or DR, DR only, VI only, both VI and DR), significant differences were found for all demographic variables (p<0.01). Those with VI and DR experienced the highest percentage of injury falls (36.6%) and the highest average number of falls per person (6.76). Controlling for sociodemographic and health conditions, those with VI and DR had significantly higher incidence rate ratios (IRR) compared to all other groups: VI only (IRR=1.17), DR only (IRR=1.90), No VI or DR (IRR=2.00). Females had a higher incidence rate than males of injury falls (IRR=1.22), and African Americans showed lower incidence rates of injury falls as compared to other races evaluated (American Indian or Alaskan Native, Hispanic, Multiracial Non-Hispanic, White).
Conclusions :
Multiple demographic factors are correlated with patients with vision impairment, diabetic retinopathy, or both VI and DR, affirming known health disparities in the US. This study revealed that individuals reporting VI and DR represent an extremely vulnerable group to a higher prevalence of falls and related injuries. Efforts should include studies of specific reasons for this disparity and tailored interventions to reduce fall morbidity. Additional screening guidelines may be developed for clinicians to better screen for fall risks, and occupational or physical therapy can potentially be developed as standards of care for patients with concomitant VI and DR.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.