Visual impairment and hip fractures: a case-control study in elderly patients.
OBJECTIVE
To investigate the relationship between visual impairment and fall-related hip fracture and to determine the etiology of visual impairment in a population of elderly patients with hip fracture.


METHODS
A case-control study compared 96 patients diagnosed with hip fracture to a randomly selected control group of 103 patients without hip fracture. Inclusion criteria for the case group were as follows: patients aged 60 years and over with a hip fracture. Clinical assessment included visual acuity and ophthalmic examination.


RESULTS
Forty-three patients with hip fracture had a visual impairment compared to only 12 patients in the control group. Visual impairment was a significant risk factor for hip fracture (OR = 6.15; 95% CI 2.98-12.69). Twenty-seven hip fracture patients had an uncorrected refractive error compared to only 15 controls (OR = 2.78; 95% CI 0.92-8.35). There was no significant difference of dense cataract between both groups (OR = 2.28; 95% CI 0.75-6.93). Fourteen hip fracture patients had a macular degeneration compared to only 8 controls (OR = 5.63; 95% CI 1.57-20.18), and 10 patients had suspicion of glaucoma compared to only 5 controls (OR = 10.65; 95% CI 2.21-51.3).


CONCLUSIONS
Visual impairment was significantly associated with an increased risk of hip fracture in elderly people. There are many etiologies that may contribute to hip fractures, most notably refractive error, cataract, macular degeneration and glaucoma.
Department of Ophthalmology, Fondation Rothschild, Paris, France.
Patrick
P
Loriaut
Philippe
P
Loriaut
Patrick
P
Boyer
Philippe
P
Massin
Isabelle
I
Cochereau
D000058:Accidental Falls; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014786:Vision Disorders / Q000209:etiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities