Abstract
Purpose :
To investigate balance changes over 3 years associated with first year fall status and baseline Fear of Falling (FoF) in glaucoma patients.
Methods :
Patients were recruited into a 3-year longitudinal cohort study in which the Opal Kinematic System (APDM Inc) characterized participants’ balance (foam pad, eyes open) annually. Balance metrics assessed were jerk, total sway, ellipse sway, and root mean square (RMS) sway. Linear regressions were performed for each balance metric to calculate slope of change over time for each participant. Fall status was assigned based on fall reports for the first study year; participants were classified as non-faller vs fallers, or absence of injurious fall(s) vs injurious faller. Fear of falling (FoF) scores were derived from Rasch analysis of the University of Illinois, Chicago FoF Questionnaire and participants were categorized into those with and without FoF using a zero logits cut-off. Separate multiple regression models evaluated changes in balance over time by faller status or FoF status controlling for age, race, sex, integrated visual field (IVF) damage, polypharmacy, and comorbidity. Additional models explored IVF damage as a potential modifier of the relationship between the faller/FoF status with balance changes over time.
Results :
Participants had a mean age of 70 (SD=7.4); half (51%) were male and one-third (30%) African American. No significant differences in balance changes over time were observed between non-fallers and fallers, those without injurious falls vs injurious fallers, or those with or without FoF for all balance metrics (p>0.05). There was a significant interaction between injurious faller status, and baseline IVF damage for ellipse (p=0.02) and rms sway (p=0.006), suggesting that injurious fallers with greater IVF damage had greater improvements in balance over time as compared to injurious fallers with less IVF damage.
Conclusions :
In glaucoma patients, fall status and baseline FoF status were not associated with changes in balance over time. Further work is required to determine the specific reasons behind the higher risk of falls in glaucoma.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.