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Affiliation
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Dana Center for Preventive Ophthalmology, Wilmer Eye Institute, Johns Hopkins University, 600 North Wolf Street, Baltimore, MD 21287. |
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Abstract
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OBJECTIVE: To determine where glaucoma patients most often fall and how integrated visual field (IVF) damage affects falls rates per year (falls/year) and per step (falls/step) at and away from home.
DESIGN: Prospective, observational cohort study METHODS: In 225 patients with glaucoma or suspected glaucoma, falls data were collected via calendars, fall location was classified through follow-up questionnaires, and steps taken at and away from home judged by integrating data from annual week-long accelerometer and GPS trials. Main outcome measures were the association of IVF sensitivity with fall rates per year or step, stratified by location.
RESULTS: Participants took more away steps than home steps (2,366 vs. 1,524, p<0.001), and differences in away vs. home steps did not vary with IVF sensitivity (p=0.22). 57% of falls occurred at home, with each home step twice as likely to result in a fall as compared to each away step (RR=2.02, p<0.001). Worse IVF sensitivity was not associated with a higher rate of home falls/year or away falls/year (p>0.1 for both), but was associated with a higher rate of home falls/step (RR=1.34/5 dB worse sensitivity, p=0.03) and away falls/step (RR=1.47/5 dB worse sensitivity, p=0.003).
CONCLUSIONS: In this glaucoma population, most falls occurred at home, and the risk of any step resulting in a fall was higher at home. Those with greater VF damage were more likely to fall for each step taken both at and away from home. Efforts such as home environmental modification should be considered in the visually impaired to prevent falls while maintaining physical activity.
Copyright © 2019 Elsevier Inc. All rights reserved.
Language: en |