title: Fear of falling and physical function in older adults with cataract: Exploring the role of vision as a moderator.
abstract: OBJECTIVE
  To examine fear of falling and associated factors in a cohort of older adults with cataract, and investigate the interplay of vision and physical function with respect to fear of falling.
  
  
  METHODS
  We analyzed baseline data from a longitudinal study of adults aged ≥65 years referred for cataract surgery. Fear of falling was assessed by the Short Falls Efficacy Scale-International. Physical function was determined by the Short Physical Performance Battery. Participants underwent assessment of visual acuity, contrast sensitivity, visual disability, quality of life, depressive symptoms, exercise frequency, comorbidity and falls history. Factors associated with fear of falling were assessed using linear regression. Planned stepwise regression investigated vision as a potential moderator of the relationship between physical function and fear of falling.
  
  
  RESULTS
  Among 322 participants, 32.9 % (n = 106) showed high fear of falling. Poorer physical function, more comorbidities and greater visual disability were independently associated with a higher fear of falling (all P < 0.001). Visual disability moderated the relationship between physical function and fear of falling (β = -0.10, P = 0.04). The impact of physical function on fear of falling was strongest in participants with higher (+1 standard deviation above the mean) visual disability (b = -0.21, P < 0.001).
  
  
  CONCLUSIONS
  Fear of falling in older adults with cataract is greatest in those with poorer physical function and higher levels of visual disability. Perceived visual ability has a moderating role in the relationship between physical function and fear of falling; physical function alone might not adequately predict falls concern. Geriatr Gerontol Int 2017; 17: 1551-1558.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, Sydney, New South Wales.
authors.forename: Anna
authors.identifier: http://orcid.org/0000-0002-8127-9351
authors.initials: A
authors.lastname: Palagyi
authors.affiliation: Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia.
authors.forename: Jonathon Q
authors.initials: JQ
authors.lastname: Ng
authors.affiliation: The George Institute for Global Health, Sydney Medical School, Sydney, New South Wales.
authors.forename: Kris
authors.initials: K
authors.lastname: Rogers
authors.affiliation: Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia.|Curtin-Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, Western Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Meuleners
authors.affiliation: Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales.
authors.forename: Peter
authors.initials: P
authors.lastname: McCluskey
authors.affiliation: Save Sight Institute, Sydney Medical School, University of Sydney, Sydney, New South Wales.|Westmead Institute for Medical Research, Sydney, New South Wales.|Westmead Hospital, Department of Ophthalmology, Sydney, New South Wales.
authors.forename: Andrew
authors.initials: A
authors.lastname: White
authors.affiliation: Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
authors.affiliation: The George Institute for Global Health, Sydney Medical School, Sydney, New South Wales.
authors.forename: Lisa
authors.initials: L
authors.lastname: Keay
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002386:Cataract / Q000523:psychology*; D003863:Depression; D015444:Exercise; D005239:Fear; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011788:Quality of Life; D012307:Risk Factors; D014792:Visual Acuity
keywords: accidental falls; aged; cataract; motor activity; vision disability