Central and Peripheral Visual Impairment and the Risk of Falls and Falls with Injury

Abstract

Objective-To evaluate central and peripheral visual impairment as independent risk factors for falls and falls with injury among adults.Design-Population-based prospective cohort study. Participants-A total of 3,203 LALES participants.Methods-Baseline presenting binocular central distance acuity was measured and impairment was classified as mild (20/40-20/63), moderate/severe (20/80 or worse). Peripheral visual impairment was classified as mild (−6dB<mean deviation<−2dB in worse eye), moderate/severe (mean deviation≤−6dB in worse eye).Main outcome measures-Falls and falls with injury in the past 12 months were assessed by self-report at 4-year follow-up visit.Results-Out of 3,203 individuals, 19% reported falls and 10% falls with injury; participants with falls were more likely to: be ≥ 60 years of age, be female, report lower income, have more than two co-morbidities, report alcohol use, report wearing bifocal glasses and report obesity. Among those who reported falls, 7% had central visual impairment (visual acuity≥20/40) compared to 4% who did not report falls; and 49% had peripheral visual impairment (mean deviation<−2dB) compared to 39% of those who did not report falls (both p-values<.0001). After adjusting for confounders, moderate to severe central and peripheral visual impairment were associated with increased risk for falls (odds ratio 2.36 95% confidence interval 1.02-5.45, p-trend= .04 and odds ratio 1.42 95% confidence interval 1.06-1.91, p-trend= .01, respectively) and with falls with injury (odds ratio 2.76 95% confidence interval 1.10-7.02, p-value= .03, and odds ratio 1.40 95% confidence interval .94-2.05, p-trend= .04, respectively). This article contains online-only material: Study GroupPublisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptOphthalmology. Author manuscript; available in PMC 2011 February 1. MethodsData for this analysis were collected as part of LALES, a population-based longitudinal study of eye disease in Latinos living in Los Angeles, California, who were 40 years of age and older at the time of study enrollment. Details of the study design and data collected have been described previously. 19 Briefly, a census of all residential households in six census tracts in La Puente was completed to identify individuals eligible to be included in the study. Eligibility included Latino (self-described) men and women who were residing in any of the six census tracts at the time of enrollment. Socio-demographic and clinical dataA brief home interview was completed after informed consent was obtained, which ...

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