Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial

Abstract

Background/aim: A third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain. Methods: 306 women aged over 70, with cataract, were randomised to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow up every 3 months. Health status was measured after 6 months. Results: Visual function improved in the operated group (corrected binocular acuity improved by 0.25 logMAR units; 8% had acuity worse than 6/12 compared with 37% of controls). Over 12 months of follow up, 76 (49%) operated participants fell at least once, and 28 (18%) fell more than once. 69 (45%) unoperated participants fell at least once, 38 (25%) fell more than once. Rate of falling was reduced by 34% in the operated group (rate ratio 0.66, 95% confidence interval 0.45 to 0.96, p = 0.03). Activity, anxiety, depression, confidence, visual disability, and handicap all improved in the operated group compared with the control group. Four participants in the operated group had fractures (3%), compared with 12 (8%) in the control group (p = 0.04). Conclusion: First eye cataract surgery reduces the rate of falling, and risk of fractures and improves visual function and general health status.

Biomarkers of aging and falling: The Beaver Dam eye study

“…Province et al (1995), Gillespie et al (2001), Li et al (2005), Faber et al (2006) suggested that significant improvements in risk of falls can be achieved through exercise programs, although this finding is not universal (Cumming et al, 2007). However, there have been few studies aimed at decreasing the risk of falls by improving visual function (Day et al, 2002;Harwood et al, 2005;Foss et al, 2006). Some of these have been limited by the poor followup for treatment (Day et al, 2002) or dealt only with cataract surgery (Harwood et al, 2005;Foss et al, 2006).…”

“…However, there have been few studies aimed at decreasing the risk of falls by improving visual function (Day et al, 2002;Harwood et al, 2005;Foss et al, 2006). Some of these have been limited by the poor followup for treatment (Day et al, 2002) or dealt only with cataract surgery (Harwood et al, 2005;Foss et al, 2006). The randomized controlled trial by Cumming et al (2007) took a more comprehensive approach to diagnosing and intervening upon vision abnormalities for the prevention of falls in older adults.…”

Visual outcome following cataract extraction in patients aged 90 years and older

“…Improvement in postural stability 8,9 and reduction of fall-related injuries and risk of fractures 10 are among the advantages achieved following this operation, and should be considered in the decision to perform cataract surgery in the very elderly.…”

Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

“…Zu den bedeutenden klientenzentrierten Endpunkten zählen z.B. die Anzahl an Stürzen (McMurdo et al, 1997;Harwood et al, 2005;Lord et al, 2005;Porthouse et al, 2005;Swanenburg et al, 2007), die Anzahl an Gestürzten (McMurdo et al, 1997;Harwood et al, 2005;Porthouse et al, 2005), die Sturzangst (Porthouse et al, 2005;Lannin, Clemson, McCluskey, Lin, Cameron, & Barras, 2007;Lin, Wolf, Hwang, Gong, & Chen, 2007) sowie die Lebensqualität (Gallagher & Brunt, 1996;Harwood, Foss, Osborn, Gregson, Zaman, & Masud, 2005;Lannin et al, 2007) und Mobilität (Lannin et al, 2007). Da die individuelle Partizipation und Teilhabe von Klienten/-innen am Leben in der Gesellschaft Handlungsmaxime und fester Bestandteil der Sozialgesetzgebung (SGB IX) sind, sind Endpunkte, die soziale Partizipation und Wertvorstellungen abbilden, stärker in den Fokus zu rücken (BAR, 2008;Welti, & Fuchs, 2007).…”