Neovascular AMD: an overlooked risk factor for injurious falls.
While those with neovascular age-related macular degeneration (NV-AMD) may be at increased risk of injurious falls risk due to poor central vision and suboptimal responses when falling, preserved peripheral vision and decreased activity levels may actually be protective. Compared with control participants, patients with NV-AMD had a significantly greater number of falls and almost twice the risk of injurious falls.


BACKGROUND
Impaired vision, particularly peripheral visual function, is a key risk factor for injurious falls. NV-AMD is a leading cause of severely impaired vision among older adults but is associated with a profound central, rather than peripheral, deficit. The objective was to determine whether older women with NV-AMD are at an increased risk of falls or injurious falls.


METHODS
We conducted a 12-month prospective cohort study of community-dwelling older (>or=70 years) women, enrolling 114 with NV-AMD and 132 without from a retinal clinic in Vancouver, Canada. Fall incidence was determined through monthly telephone follow-up, with fall severity classified by a blinded reviewer. We compared mean injurious falls per person-year between groups using negative binomial regression.


RESULTS
A mean of 0.37 injurious falls per person-year were experienced among NV-AMD participants, compared to 0.16 injurious falls per person-year among non-NV-AMD participants (p = 0.006). The age-adjusted incidence rate ratio for injurious falls, for an individual with NV-AMD compared to without, was 1.77 (1.07-3.02).


CONCLUSIONS
Older women with NV-AMD are at almost twice the risk of injurious falls compared to those without. Clinicians caring for older adults should recognise NV-AMD as an important risk factor for injurious falls.
Szabo
S M
SM
School of Population and Public Health & Epidemiology, University of British Columbia, Vancouver, British Columbia, Canada. shelagh.szabo@oxfordoutcomes.com
Janssen
P A
PA
Khan
K
K
Lord
S R
SR
Potter
M J
MJ
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000150:complications*; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D012307:Risk Factors; D015354:Vision, Low / Q000209:etiology; D014947:Wounds and Injuries / Q000209:etiology*