Falls in elderly patients with glaucoma.
We analyzed the determinants of serious falls among 489 ambulatory elders aged 65 years and older who received a comprehensive examination at a glaucoma consultation service. For the previous year, at least one fall requiring medical attention or restricted activity was reported by 9.6% (95% confidence interval [CI], 7.0% to 12.2%) of participants. Using logistic regression to adjust for potential confounding variables, the greatest single risk factor for falls was the use of nonmiotic topical eye medications (odds ratio [OR], 5.4; 95% Cl, 1.8 to 16.4). Additional risk factors for falls were female sex (OR, 2.3; 95% Cl, 1.1 to 4.7) and use of cardiac medications (OR, 2.5; 95% Cl, 1.1 to 5.6). Three other characteristics were also associated with the risk of falls: use of miotic eye medications (OR, 3.2; 95% Cl, 1.0 to 10.1); visual field impairment of 40% or greater (OR, 3.0; 95% Cl, 0.94 to 9.8); and use of sedatives (OR, 2.4; 95% Cl, 0.89 to 6.7). These findings suggest that ocular and systemic medications are the major predictors of falls even in this elderly population seeking ophthalmologic care for glaucoma. Medications appear to pose a greater risk for falls than even major visual impairment.
Glynn
R J
RJ
Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.
Seddon
J M
JM
Krug
J H
JH
Sahagian
C R
CR
Chiavelli
M E
ME
Campion
E W
EW
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000009:adverse effects; D005260:Female; D005901:Glaucoma / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000627:therapeutic use; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D014794:Visual Fields
D002317:Cardiovascular Agents; D006993:Hypnotics and Sedatives; D009883:Ophthalmic Solutions