Older adults with cataracts, age-related macular degeneration (AMD), and glaucoma have a higher risk of falls and fractures, according to a population-based cohort study out of the United Kingdom.
The study authors concluded that people with vision loss from these diseases would “likely benefit from improved advice, access, and referrals to falls prevention services and targeted interventions to prevent related adverse outcomes”.
In the study, published in JAMA Ophthalmology,1 the authors said these three leading causes of age-related vision loss have been implicated with falls and fractures risk, “although the evidence is mixed, with the contribution of different eye diseases being uncertain.”
The Cohort Study
The cohort study examined the electronic medical record data from England for adults from 2007–2020.
A total of 410,476 people with cataract; 75,622 with AMD; and 90,177 with glaucoma were matched (1:5) to 2,034,194 (no cataract); 375,548 (no AMD); and 448.179 (no glaucoma) comparators.
The mean age was 73.8 years, 79.4 years, and 69.8 years for participants with cataract, AMD, or glaucoma, respectively.
Compared with comparators, there was an increased risk of falls in those with cataract (adjusted hazard ratio [HR], 1.36; 95% CI, 1.35-1.38), AMD (HR, 1.25; 95% CI, 1.23-1.27), and glaucoma (HR, 1.38; 95% CI, 1.35-1.41). Likewise for fractures, there were increased risks in all eye diseases, with an HR of 1.28 (95% CI, 1.27-1.30) in the cataract cohort, an HR of 1.18 (95% CI, 1.15-1.21) for AMD, and an HR of 1.31 (95% CI, 1.27-1.35) for glaucoma.
Site-specific fracture analyses revealed increases in almost all body sites (including hip, spine, forearm, skull or facial bones, pelvis, ribs or sternum, and lower leg fractures) compared with matched comparators.
clinicians who treat eye diseases can help patients by talking to them about falls risk, and referring them to a fall prevention program
Warn Patients About Falls Risks
The findings suggest that clinicians who treat eye diseases can help patients by talking to them about falls risk, and referring them to a fall prevention program, researcher Dr Jung Yin Tsang said in an interview with online news organisation, MedPage Today.
“All that may be needed is that at-risk patients can be given some extra advice or pointed in the right direction, so we avoid missed opportunities to prevent falls.
“Our study is observational, so we don’t know the exact connection… based on previous research, it’s likely a mixture of vision, balance, poorer hazard perception, and unmeasured factors. Even mild eye disease appears to increase your fall risk.”
Reference
- Tsang, J.Y.Wright, A.Carr, M.J., et al. Risk of falls and fractures in individuals with cataract, age-related macular degeneration, or glaucoma. JAMA Ophthalmol. Published online 28 December 2023. DOI:10.1001/jamaophthalmol.2023.5858
