title: Activity limitation due to a fear of falling in older adults with eye disease.
abstract: OBJECTIVE
  To examine whether patients with age-related macular degeneration (AMD), glaucoma, or Fuchs corneal dystrophy report limiting their activity due to a fear of falling as compared with a control group of older adults with good vision.
  
  
  METHODS
  We recruited 345 patients (93 with AMD, 57 with Fuchs, 98 with glaucoma, and 97 controls) from the ophthalmology clinics of Maisonneuve-Rosemont Hospital (Montreal, Canada) to participate in a cross-sectional study from September 2009 until July 2012. Control patients who had normal visual acuity and visual field were recruited from the same clinics. Participants were asked if they limited their activity due to a fear of falling. Visual acuity, contrast sensitivity, and visual field were measured and the medical record was reviewed.
  
  
  RESULTS
  Between 40% and 50% of patients with eye disease reported activity limitation due to a fear of falling compared with only 16% of controls with normal vision. After adjustment for age, sex, race, number of comorbidities, cognition, and lens opacity, the Fuchs groups was most likely to report activity limitation due to a fear of falling (odds ratio [OR] = 3.07; 95% confidence interval [CI], 1.33-7.06) followed by the glaucoma group (OR = 2.84; 95% CI, 1.36-5.96) and the AMD group (OR = 2.42; 95% CI, 1.09-5.35). Contrast sensitivity best explained these associations.
  
  
  CONCLUSIONS
  Activity limitation due to a fear of falling is very common in older adults with visually impairing eye disease. Although this compensatory strategy may protect against falls, it may also put people at risk for social isolation and disability.
authors.affiliation: Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montreal, Quebec, Canada.
authors.forename: Meng Ying
authors.initials: MY
authors.lastname: Wang
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Rousseau
authors.forename: Hélène
authors.initials: H
authors.lastname: Boisjoly
authors.forename: Heidi
authors.initials: H
authors.lastname: Schmaltz
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.forename: Solmaz
authors.initials: S
authors.lastname: Moghadaszadeh
authors.forename: Fawzia
authors.initials: F
authors.lastname: Djafari
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Freeman
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology; D003430:Cross-Sectional Studies; D005239:Fear / Q000523:psychology; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000523:psychology*; D005901:Glaucoma / Q000523:psychology*; D006801:Humans; D008268:Macular Degeneration / Q000523:psychology*; D008297:Male; D051346:Mobility Limitation; D014786:Vision Disorders / Q000523:psychology; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000523:psychology*