The association between various visual function tests and low fragility hip fractures among the elderly: a Malaysian experience.
BACKGROUND
hip fractures are an increasing source of morbidity and mortality in older people. The role of visual function tests such as visual impairment, stereopsis, contrast sensitivity and visual field defects in low fragility hip fractures in Asian populations is not well understood.


OBJECTIVE
to determine the association between various visual function tests and low fragility hip fractures in an Asian population.


METHODS
case-control study.


METHODS
University Malaya Medical Centre, Kuala Lumpur, Malaysia.


METHODS
108 cases aged > or = 55 years admitted with low fragility fractures and 108 controls (matched for age, gender and race).


METHODS
both cases and controls underwent a detailed ophthalmological examination, which included visual acuity, stereopsis, contrast sensitivity and visual field testing.


RESULTS
poorer visual acuity (odds ratio, OR = 4.08; 95% confidence interval, CI: 1.44, 11.51), stereopsis (OR = 3.60, 95% CI: 1.55, 8.38), contrast sensitivity (OR = 3.34, 95% CI: 1.48, 7.57) and visual field defects (OR = 11.60, 95% CI: 5.21, 25.81) increased the risk of fracture. Increased falls were associated with poorer visual acuity (OR = 2.30, 95% CI: 1.04, 5.13), stereopsis (OR = 2.11, 95% CI: 1.03, 4.32), contrast sensitivity (OR = 2.12, 95% CI: 1.05, 4.30) and visual field defects (OR = 3.40, 95% CI: 1.69, 6.86).


CONCLUSIONS
impaired visual acuity, stereopsis, contrast sensitivity and visual field defects are associated with an increased risk of low fragility hip fractures. We recommend that all patients aged > or = 55 should have an annual ophthalmological examination that includes visual acuity, contrast sensitivity, stereopsis and visual field testing to assess the risks for falls and low fragility fractures.
Chew
Fiona L M
FL
Department of Ophthalmology, University Malaya, Jalan Universiti, Kuala Lumpur, Wilayah Persekutuan 50603, Malaysia.
Yong
Chee-Khuen
CK
Mas Ayu
S
S
Tajunisah
I
I
D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D016022:Case-Control Studies; D003867:Depth Perception; D005260:Female; D006620:Hip Fractures / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000150:complications*; D014792:Visual Acuity