The activities of daily vision scale: a useful tool to assess fall risk in older adults with vision impairment.
OBJECTIVE
To evaluate the validity of the Activities of Daily Vision Scale (ADVS) as a tool to assess fall risk in older adults with vision impairment.


METHODS
Cross-sectional assessments of visual function and retrospective collection of fall data.


METHODS
The outpatient medical clinics of an academic tertiary care community hospital.


METHODS
Randomly selected sample (n = 143) of older (> or = 65 years) patients seen at the outpatient medical clinics at Nassau County Medical Center in Long Island, New York. These patients had one or more of five ocular conditions: refractive errors (n = 90), cataracts (n = 77), glaucoma (n = 29), diabetic retinopathy (n = 19), and/or macular degeneration (n = 6).


METHODS
Visual function, assessed using the ADVS, demonstrated scores ranging from 0 (marked visual disability) to 100 (no visual difficulty). Fall history and the presence of eye disease were based on the self-recall of patients. Fall history was assessed retrospectively over a 1-year period from the time of the interview.


RESULTS
Thirteen percent of the subjects reported having one or more falls during the 1-year period before the time of the interview. These subjects scored significantly lower on the ADVS compared with the scores of the group that did not report falls (74 +/- 22 vs 85 +/- 14, P < .01). Using a cutoff score of 90 points (10% loss of visual function on the ADVS), the ADVS had a 67% sensitivity in identifying those patients who had falls. Among the patients with glaucoma and those with diabetic retinopathy, the ADVS had a 100% sensitivity in identifying those patients who reported a history of falls. In patients with cataracts and refractive errors, the ADVS had a sensitivity of 82% and 64%, respectively, in identifying patients with a history of falls. The number of falls reported by the subjects showed no relationship with the ADVS scores.


CONCLUSIONS
The results from this study suggest that the ADVS may prove to be a useful tool to assess fall risk in older adults with vision impairment, especially in those persons with glaucoma, diabetic retinopathy, and/or cataracts.
Kamel
H K
HK
Division of Geriatric Medicine, Saint Louis University School of Medicine, Missouri 63104, USA.
Guro-Razuman
S
S
Shareeff
M
M
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009518:New York; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000145:classification / Q000150:complications*