TY - JOUR
T1 - Risk of falls, injurious falls, and other injuries resulting from visual impairment among older adults with age-related macular degeneration
AU - Wood, Joanne M.
AU - Lacherez, Philippe
AU - Black, Alex A.
AU - Cole, Michael H.
AU - Boon, Mei Ying
AU - Kerr, Graham K.
PY - 2011/7
Y1 - 2011/7
N2 - Purpose. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment among older adults. This study explored the relationship between AMD, fall risk, and other injuries and identified visual risk factors for these adverse events. Methods. Participants included 76 community-dwelling individuals with a range of severity of AMD (mean age, 77.0 ± 6.9 years). Baseline assessment included binocular visual acuity, contrast sensitivity, and merged visual fields. Participants completed monthly falls and injury diaries for 1 year after the baseline assessment. Results. Overall, 74% of participants reported having either a fall or a non-fall-related injury. Fifty-four percent of participants reported a fall and 30% reported more than one fall; of the 102 falls reported, 63% resulted in an injury. Most occurred outdoors (52%), between late morning and late afternoon (61%) and when navigating on level ground (62%). The most common non-fall-related injuries were lacerations (36%) and collisions with an object (35%). Reduced contrast sensitivity and visual acuity were associated with increased fall rate, after controlling for age, sex, cognitive function, cataract severity, and self-reported physical function. Reduced contrast sensitivity was the only significant predictor of non-fall-related injuries. Conclusions. Among older adults with AMD, increased visual impairment was significantly associated with an increased incidence of falls and other injuries. Reduced contrast sensitivity was significantly associated with both increased rates of falls and other injuries, while reduced visual acuity was only associated with increased fall rate. These findings have important implications for the assessment of visually impaired older adults.
AB - Purpose. Age-related macular degeneration (AMD) is the leading cause of irreversible visual impairment among older adults. This study explored the relationship between AMD, fall risk, and other injuries and identified visual risk factors for these adverse events. Methods. Participants included 76 community-dwelling individuals with a range of severity of AMD (mean age, 77.0 ± 6.9 years). Baseline assessment included binocular visual acuity, contrast sensitivity, and merged visual fields. Participants completed monthly falls and injury diaries for 1 year after the baseline assessment. Results. Overall, 74% of participants reported having either a fall or a non-fall-related injury. Fifty-four percent of participants reported a fall and 30% reported more than one fall; of the 102 falls reported, 63% resulted in an injury. Most occurred outdoors (52%), between late morning and late afternoon (61%) and when navigating on level ground (62%). The most common non-fall-related injuries were lacerations (36%) and collisions with an object (35%). Reduced contrast sensitivity and visual acuity were associated with increased fall rate, after controlling for age, sex, cognitive function, cataract severity, and self-reported physical function. Reduced contrast sensitivity was the only significant predictor of non-fall-related injuries. Conclusions. Among older adults with AMD, increased visual impairment was significantly associated with an increased incidence of falls and other injuries. Reduced contrast sensitivity was significantly associated with both increased rates of falls and other injuries, while reduced visual acuity was only associated with increased fall rate. These findings have important implications for the assessment of visually impaired older adults.
UR - http://www.scopus.com/inward/record.url?scp=80052534261&partnerID=8YFLogxK
U2 - 10.1167/iovs.10-6644
DO - 10.1167/iovs.10-6644
M3 - Article
C2 - 21474773
AN - SCOPUS:80052534261
SN - 0146-0404
VL - 52
SP - 5088
EP - 5092
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 8
ER -