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Visual impairment, postural stability and falls among older adults with glaucoma

Black, Alex A., Wood, Joanne M., Lovie-Kitchin, Jan E., & Newman, Beth M. (2009) Visual impairment, postural stability and falls among older adults with glaucoma. In Proceedings of the 12 Biennial Scientific and Educators' Meeting in Optometry, Optometrists Association Australia, University of Auckland, Auckland.

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Abstract

Purpose: To investigate the impact of glaucomatous visual impairment on postural sway and falls among older adults.Methods: The sample comprised 72 community-dwelling older adults with open-angle glaucoma, aged 74.0 5.8 years (range 62 to 90 years). Measures of visual function included binocular visual acuity (high-contrast), binocular contrast sensitivity (Pelli- Robson) and binocular visual fields (merged monocular HFA 24-2 SITA-Std). Postural stability was assessed under four conditions: eyes open and closed, on a firm and on a foam surface. Falls were monitored for six months with prospective falls diaries. Regression models, adjusting for age and gender, examined the association between vision measures and postural stability (linear regression) and the number of falls (negative binomial regression). Results: Greater visual field loss was significantly associated with poorer postural stability with eyes open, both on firm (r = 0.34, p < 0.01) and foam (r = 0.45, p < 0.001) surfaces. Eighteen (25 per cent) participants experienced at least one fall: 12 (17 per cent) participants fell only once and six (eight per cent) participants fell two or more times (up to five falls). Visual field loss was significantly associated with falling; the rate of falls doubled for every 10 dB reduction in field sensitivity (rate ratio = 1.08, 95% CI = 1.02–1.13). Importantly, in a model comprising upper and lower field sensitivity, only lower field loss was significantly associated with the number of falls (rate ratio = 1.17, 95% CI = 1.04–1.33). Conclusions: Binocular visual field loss was significantly associated with postural instability and falls among older adults with glaucoma. These findings provide valuable directions for developing falls risk assessment and falls prevention strategies for this population.

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ID Code: 31461
Item Type: Conference Paper
Additional Information: The abstract of this paper was published in "Clinical and Experimental Optometry", Vol. 92, no. 1, pp.51-69. [please see DOI].
DOI: 10.1111/j.1444-0938.2008.00341.x
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Deposited On: 24 Mar 2010 08:05
Last Modified: 22 Apr 2010 02:29

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