title: Visual field loss and risk of fractures in older women.
abstract: OBJECTIVE
  To evaluate the associations between visual field loss and nonspine fractures.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Community.
  
  
  METHODS
  Four thousand seven hundred seventy-three community-dwelling white and African-American women aged 65 and older with no previous history of hip fracture at the time of recruitment.
  
  
  METHODS
  Radiographically confirmed hip and nonspine, nonhip fractures identified from September 1997 to April 2008. Visual field loss was measured using a Humphrey Field Analyzer suprathreshold screening test of the peripheral and central vision of each eye and was classified into an ordinal rating of no, mild, moderate, or severe binocular visual field (BVF) loss.
  
  
  RESULTS
  For hip and nonspine, nonhip fractures and in unadjusted and covariate-adjusted analyses, the highest incidence of fractures was seen in women with the most-severe BVF loss. In covariate-adjusted analysis, women with mild, moderate, and severe BVF loss had a 49% (hazard ratio (HR)=1.49, 95% confidence interval (CI)=1.18-1.88), 25% (HR=1.25, 95% CI=0.87-1.80), and 66% (HR=1.66, 95% CI=1.19-2.32) greater risk, respectively, for hip fractures than women without BVF loss. Similarly, women with mild visual field loss had a 12% (HR=0.88, 95% CI=0.75-1.04) lower risk for nonspine, nonhip fractures, whereas women with moderate and severe visual field loss had a 18% (HR=1.18, 95% CI=0.92-1.52) and 59% (HR=1.59, 95% CI=1.24-2.03) greater risk of nonspine, nonhip fractures than women without BVF loss.
  
  
  CONCLUSIONS
  BVF loss is independently associated with hip and nonspine, nonhip fractures in older female volunteers.
authors.affiliation: Jules Stein Eye Institute, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, California, USA. coleman@jsei.ucla.edu
authors.forename: Anne L
authors.initials: AL
authors.lastname: Coleman
authors.forename: Steven R
authors.initials: SR
authors.lastname: Cummings
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
authors.forename: Fei
authors.initials: F
authors.lastname: Yu
authors.forename: Peter
authors.initials: P
authors.lastname: Gutierrez
authors.forename: Katie L
authors.initials: KL
authors.lastname: Stone
authors.forename: Jane A
authors.initials: JA
authors.lastname: Cauley
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Pedula
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
authors.forename: Carol M
authors.initials: CM
authors.lastname: Mangione
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D050723:Fractures, Bone / Q000150:complications* / Q000453:epidemiology*; D006801:Humans; D011446:Prospective Studies; D012307:Risk Factors; D014786:Vision Disorders / Q000150:complications* / Q000453:epidemiology*; D014794:Visual Fields
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