TY  - JOUR
PY  - 2010//
TI  - Central and Peripheral Visual Impairment and the Risk of Falls and Falls with Injury
JO  - Ophthalmology
A1  - Patino, Cecilia M.
A1  - McKean-Cowdin, Roberta
A1  - Azen, Stanley P.
A1  - Allison, Jessica Chung
A1  - Choudhury, Farzana
A1  - Varma, Rohit
SP  - 199
EP  - 206.e1
VL  - 117
IS  - 2
N2  - OBJECTIVE: To evaluate whether central (CVI) and peripheral visual impairment (PVI) are independent risk factors for falls and falls with injury 4 years later. DESIGN: Population-based, prospective cohort study. PARTICIPANTS: A population-based sample of 3203 adult Latinos. METHODS: Baseline presenting binocular central distance acuity was measured and impairment was classified as mild (20/40-20/63) or moderate/severe (</=20/80). Peripheral visual impairment was classified as mild (-6 dB < mean deviation < -2 dB in worse eye), moderate/severe (mean deviation </= -6 dB in worse eye). MAIN OUTCOME MEASURES: Falls and falls with injury in the past 12 months were assessed by self-report at the 4-year follow-up visit. RESULTS: Out of 3203 individuals, 19% reported falls and 10% falls with injury 4 years after the baseline examination; participants with falls were more likely to be >/=60 years of age, be female, report lower income, have >2 comorbidities, report alcohol use, report wearing bifocal glasses, and report obesity. Among those who reported falls, 7% had CVI and 49% had PVI, compared with the 4% and 39% of those with CVI and PVI, respectively, who did not report falls. After adjusting for confounders, moderate to severe CVI and PVI were associated with increased risk for falls (odds ratio [OR], 2.36; 95% confidence interval [CI], 1.02-5.45; P(trend) = 0.04; and OR, 1.42; 95% CI, 1.06-1.91l P(trend) = 0.01, respectively) and with falls with injury (OR, 2.76; 95% CI, 1.10-7.02; P(value) = 0.03; and OR, 1.40; 95% CI, 0.94-2.05 P(trend) = 0.04, respectively). CONCLUSIONS: Both CVI and PVI were independently associated with increased risk for falls and falls with injury 4 years after the initial examination in a dose-response manner. Although vision-related interventions for preventing falls have mainly focused on correcting CVI, this study suggests that targeting both central and peripheral components may be necessary to effectively reduce rates of falls and falls with injury related to vision loss. FINANCIAL DISCLOSURE(S): The authors have no proprietary or commercial interest in any of the materials discussed in this article.<p />  <p>Language: en</p>
LA  - en
SN  - 0161-6420
UR  - http://dx.doi.org/10.1016/j.ophtha.2009.06.063
ID  - ref1
ER  -