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. 2021 Jul:227:275-283.
doi: 10.1016/j.ajo.2021.02.017. Epub 2021 Feb 21.

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

Anjali M Bhorade  1 , Monica S Perlmutter  2 , Sharon L Sabapathypillai  3 , Manik Goel  3 , Bradley Wilson  3 , Mae O Gordon  3
Affiliations

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

Anjali M Bhorade et al. Am J Ophthalmol. 2021 Jul.

Abstract

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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Figures

Figure 1:
Figure 1:
Percent of participants with 95% confidence intervals self-reporting ≥ 1 fall in the prior 12 months, high fear of falling, and high avoidance of at least one activity at-risk for falls in the control and glaucoma groups.
Figure 2:
Figure 2:
Percent of participants with 95% confidence intervals self-reporting ≥ 1 fall in the prior 12 months, high fear of falling, and high avoidance of at least one activity at-risk for falls in the control group and mild, moderate, and advanced glaucoma subgroups.
See this image and copyright information in PMC

References

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