Jonathan Thomas, Louay Almidani, Pradeep Ramulu, Varshini Varadaraj
{"title":"美国视力受损老年人中的跌倒和多次跌倒。","authors":"Jonathan Thomas, Louay Almidani, Pradeep Ramulu, Varshini Varadaraj","doi":"10.1016/j.ajo.2024.11.012","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To examine the cross-sectional and longitudinal associations between visual impairment (VI) and falls in United States older adults.</p><p><strong>Design: </strong>Retrospective cross-sectional and cohort study.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Aging Trends Study 2021 and 2022. Participants were Medicare beneficiaries ≥71 years. Exposures were any VI - defined as distance or near VI (>0.3 logMAR), or contrast sensitivity (CS) impairment (<1.55 logCS) -and changes in distance visual acuity ([DVA], logMAR/y), near visual acuity ([NVA], logMAR/y), or CS (logCS/y). Outcomes were self-reported falls in the past 12 months.</p><p><strong>Results: </strong>2822 participants were included in the analysis. At baseline, adults with any VI had greater rates of falls (rate ratio = 1.16, 95% CI = 1.04-1.30) and multiple falls (rate ratio = 1.23, 95% CI = 1.01-1.49) than peers without VI. In longitudinal analysis, adults with any VI at baseline did not have a greater risk of falls or multiple falls in the following year compared to peers without VI; only worse CS (hazard ratio [HR] = 1.03, 95% CI = 1.01-1.06, per 0.1 logCS worse) and DVA (HR = 1.11, 95% CI = 1.04-1.18, per 0.1 logMAR worse) were associated with a greater risk of falls and multiple falls, respectively. However, in other models, change in NVA (HR = 1.04, 95% CI = 1.01-1.08, per 0.1 logMAR worse/y) was associated with greater fall risk over the follow-up period. Further, change in CS (HR = 1.11, 95% CI = 1.05-1.18, per 0.1 logCS worse/y) was associated with a greater risk of multiple falls, while changes in DVA and NVA were not.</p><p><strong>Conclusions: </strong>Older United States adults with VI are more likely to experience a fall, with various components of their vision influencing the fall risk.</p>","PeriodicalId":7568,"journal":{"name":"American Journal of Ophthalmology","volume":" ","pages":"166-174"},"PeriodicalIF":4.1000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Falls and Multiple Falls Among United States Older Adults With Vision Impairment.\",\"authors\":\"Jonathan Thomas, Louay Almidani, Pradeep Ramulu, Varshini Varadaraj\",\"doi\":\"10.1016/j.ajo.2024.11.012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To examine the cross-sectional and longitudinal associations between visual impairment (VI) and falls in United States older adults.</p><p><strong>Design: </strong>Retrospective cross-sectional and cohort study.</p><p><strong>Methods: </strong>This study utilized data from the National Health and Aging Trends Study 2021 and 2022. Participants were Medicare beneficiaries ≥71 years. Exposures were any VI - defined as distance or near VI (>0.3 logMAR), or contrast sensitivity (CS) impairment (<1.55 logCS) -and changes in distance visual acuity ([DVA], logMAR/y), near visual acuity ([NVA], logMAR/y), or CS (logCS/y). Outcomes were self-reported falls in the past 12 months.</p><p><strong>Results: </strong>2822 participants were included in the analysis. At baseline, adults with any VI had greater rates of falls (rate ratio = 1.16, 95% CI = 1.04-1.30) and multiple falls (rate ratio = 1.23, 95% CI = 1.01-1.49) than peers without VI. In longitudinal analysis, adults with any VI at baseline did not have a greater risk of falls or multiple falls in the following year compared to peers without VI; only worse CS (hazard ratio [HR] = 1.03, 95% CI = 1.01-1.06, per 0.1 logCS worse) and DVA (HR = 1.11, 95% CI = 1.04-1.18, per 0.1 logMAR worse) were associated with a greater risk of falls and multiple falls, respectively. However, in other models, change in NVA (HR = 1.04, 95% CI = 1.01-1.08, per 0.1 logMAR worse/y) was associated with greater fall risk over the follow-up period. Further, change in CS (HR = 1.11, 95% CI = 1.05-1.18, per 0.1 logCS worse/y) was associated with a greater risk of multiple falls, while changes in DVA and NVA were not.</p><p><strong>Conclusions: </strong>Older United States adults with VI are more likely to experience a fall, with various components of their vision influencing the fall risk.</p>\",\"PeriodicalId\":7568,\"journal\":{\"name\":\"American Journal of Ophthalmology\",\"volume\":\" \",\"pages\":\"166-174\"},\"PeriodicalIF\":4.1000,\"publicationDate\":\"2024-11-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Ophthalmology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.ajo.2024.11.012\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.ajo.2024.11.012","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Falls and Multiple Falls Among United States Older Adults With Vision Impairment.
Purpose: To examine the cross-sectional and longitudinal associations between visual impairment (VI) and falls in United States older adults.
Design: Retrospective cross-sectional and cohort study.
Methods: This study utilized data from the National Health and Aging Trends Study 2021 and 2022. Participants were Medicare beneficiaries ≥71 years. Exposures were any VI - defined as distance or near VI (>0.3 logMAR), or contrast sensitivity (CS) impairment (<1.55 logCS) -and changes in distance visual acuity ([DVA], logMAR/y), near visual acuity ([NVA], logMAR/y), or CS (logCS/y). Outcomes were self-reported falls in the past 12 months.
Results: 2822 participants were included in the analysis. At baseline, adults with any VI had greater rates of falls (rate ratio = 1.16, 95% CI = 1.04-1.30) and multiple falls (rate ratio = 1.23, 95% CI = 1.01-1.49) than peers without VI. In longitudinal analysis, adults with any VI at baseline did not have a greater risk of falls or multiple falls in the following year compared to peers without VI; only worse CS (hazard ratio [HR] = 1.03, 95% CI = 1.01-1.06, per 0.1 logCS worse) and DVA (HR = 1.11, 95% CI = 1.04-1.18, per 0.1 logMAR worse) were associated with a greater risk of falls and multiple falls, respectively. However, in other models, change in NVA (HR = 1.04, 95% CI = 1.01-1.08, per 0.1 logMAR worse/y) was associated with greater fall risk over the follow-up period. Further, change in CS (HR = 1.11, 95% CI = 1.05-1.18, per 0.1 logCS worse/y) was associated with a greater risk of multiple falls, while changes in DVA and NVA were not.
Conclusions: Older United States adults with VI are more likely to experience a fall, with various components of their vision influencing the fall risk.
期刊介绍:
The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect.
The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports.
Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.