People with 1 or more eye diseases, such as cataract, age-related macular degeneration (AMD) and glaucoma, are at increased risk of both falls and fractures, according to findings from a recent study. Improved advice, access, and referrals to falls prevention services may help patients, concluded the study researchers.
Age-related visual loss is thought to be associated with falls and fracture risk, although the evidence is unclear. This cohort population-based study in England used electronic health records with linked hospitalization and mortality records from 2007 to 2020 to evaluate whether people with cataract, AMD, or glaucoma have higher risks of falls or fractures than those without. Participants included people with cataract, AMD, or glaucoma matched to comparators by age, sex, and general practice. Data were analyzed from May 2021 to June 2023. For each eye disease, the researchers estimated the risk of falls or fractures using separate multivariable Cox proportional hazards regression models. The primary outcomes were incident falls and incident fractures derived from general practice, hospital, and mortality records, while secondary outcomes were incident fractures of specific body sites.
A total of 410,476 people with cataract, 75,622 with AMD, and 90,177 with glaucoma were matched to 2,034,194 (no cataract), 375,548 (no AMD), and 448,179 (no glaucoma) comparators. The mean (SD) 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), AMD (HR, 1.25), and glaucoma (HR, 1.38). For fractures, there were increased risks in all eye diseases, with an HR of 1.28 in the cataract cohort, an HR of 1.18 for AMD, and an HR of 1.31 for glaucoma. Site-specific fracture analyses revealed increases in numerous body sites (hip, spine, forearm, skull or facial bones, pelvis, ribs or sternum, and lower leg fractures) compared with matched comparators.
Reference:
Tsang JY, Wright A, Carr MJ, et al. Risk of falls and fractures in individuals with cataract, age-related macular degeneration, or glaucoma. JAMA Ophthalmol. Published online Dec 28, 2023. doi:10.1001/jamaophthalmol.2023.5858
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