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Rate of Falls, Fear of Falling, and Avoidance of Activities At-Risk for Falls in Older Adults With Glaucoma

  • Anjali M. Bhorade
    Correspondence
    Inquiries to Anjali Bhorade, Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8096, St. Louis, MO 63110, USA
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA

    the Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Monica S. Perlmutter
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA

    the Program in Occupational Therapy, Washington University School of Medicine, St. Louis, Missouri, USA
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  • Sharon L. Sabapathypillai
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA
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  • Manik Goel
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA
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  • Bradley Wilson
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA
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  • Mae O. Gordon
    Affiliations
    From the Department of Ophthalmology and Visual Sciences (A.M.B., M.S.P., S.L.S., M.G., B.W., M.G.), Washington University School of Medicine (M.S.P.), St. Louis, Missouri, USA
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Published:February 21, 2021DOI:https://doi.org/10.1016/j.ajo.2021.02.017

      Purpose

      To determine the relationship between glaucoma severity and rate of falls, fear of falling, and avoidance of activities at-risk for falls.

      Design

      Cross-sectional study.

      Methods

      Patients with glaucoma (n = 138) 55 to 90 years of age with mild (n = 61), moderate (n = 54), or advanced (n = 23) glaucoma in the better eye based on the Glaucoma Staging System and age-matched control subjects (n = 50) were recruited from the Eye Clinics at Washington University, St. Louis, MO. Participants completed questionnaires regarding falls, the fear of falling, and the avoidance of activities at-risk for falls.

      Results

      Of the glaucoma participants, 36% reported ≥1 fall in the previous 12 months compared with 20% of control subjects (adjusted odds ratio [OR] 2.7 [95% confidence interval {CI} 1.18-6.17]; P = .018). Compared with control subjects, the mild glaucoma group trended toward a higher fall risk (adjusted OR 2.43 [95% CI 0.97-6.08]; P = .059) and the advanced group had the highest fall risk (adjusted OR 7.97 [95% CI 2.44-26.07]; P = .001). A greater risk of a high fear of falling and high avoidance of at-risk activities occurred at the moderate stage of glaucoma compared with control subjects (adjusted OR 4.66 [95% CI 1.24-17.49]; P = .023 and adjusted OR 4.49 [95% CI 1.34-15.05]; P = .015, respectively).

      Conclusions

      Patient education, interventions, and appropriate referrals to minimize falls should be considered in older adults with early glaucoma and continue with advancing disease. Minimizing a patient's fall risk may decrease their fear of falling and avoidance of at-risk activities. Reducing falls, the fear of falling, and the avoidance of at-risk activities may lower morbidity and mortality and improve emotional and social well-being of patients with glaucoma. Am J Ophthalmol 2021;221:•••–•••. © 2021 Elsevier Inc. All rights reserved.
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      References

      1. Centers for Disease Control and Prevention website. WISQARS (Web-based Injury Statistics Query and Reporting System). Available at: www.cdc.gov/injury/wisqars/index.html. Accessed April 21, 2020.

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