Coleman Anne L, Cummings Steven R, Yu Fei, Kodjebacheva Gergana, Ensrud Kristine E, Gutierrez Peter, Stone Katie L, Cauley Jane A, Pedula Kathryn L, Hochberg Marc C, Mangione Carol M
Jules Stein Eye Institute, Los Angeles, CA 90095, USA.
J Am Geriatr Soc. 2007 Mar;55(3):357-64. doi: 10.1111/j.1532-5415.2007.01094.x.
To examine the relationship between binocular visual field loss and the risk of incident frequent falls in older white women.
A multicenter, prospective cohort study.
Four clinic centers within the United States in Baltimore, Maryland; Minneapolis, Minnesota; Portland, Oregon; and the Monongahela Valley, Pennsylvania.
Four thousand seventy-one community-dwelling white women aged 70 and older participating in the Study of Osteoporotic Fractures.
Primary outcome was incident frequent falls, defined as two or more falls within 1 year. Primary risk factors were binocular visual field loss, distance visual acuity in the better eye, and contrast sensitivity at low spatial frequency in the better eye.
Of 4,071 women, 409 (10%) had severe binocular visual field loss at the eye examination, and 643 (16%) experienced frequent falls within 1 year after their eye examination. Severe binocular visual field loss was significantly associated with frequent falls when adjusting for age, study site, and cognitive function (odds ratio=1.50, 95% confidence interval=1.11-2.02). The data showed a trend for increasing odds of two or more falls with greater binocular visual field loss (P<.001). In older white women with severe binocular visual field loss, 33.3% of frequent falls were attributable to visual field loss.
Women with binocular visual field loss are at greater risk of future frequent falls. Screening for binocular visual field loss may identify individuals at high risk of falling.
研究老年白人女性双眼视野缺损与频发跌倒风险之间的关系。
一项多中心前瞻性队列研究。
美国马里兰州巴尔的摩、明尼苏达州明尼阿波利斯、俄勒冈州波特兰以及宾夕法尼亚州莫农加希拉谷的四个诊所中心。
4071名年龄在70岁及以上的社区居住白人女性，她们参与了骨质疏松性骨折研究。
主要结局是频发跌倒，定义为1年内跌倒两次或更多次。主要危险因素是双眼视野缺损、较好眼的远视力以及较好眼在低空间频率下的对比敏感度。
在4071名女性中，409名（10%）在眼部检查时有严重双眼视野缺损，643名（16%）在眼部检查后1年内经历了频发跌倒。在对年龄、研究地点和认知功能进行校正后，严重双眼视野缺损与频发跌倒显著相关（比值比=1.50，95%置信区间=1.11 - 2.02）。数据显示，双眼视野缺损越严重，跌倒两次或更多次的几率呈上升趋势（P<0.001）。在有严重双眼视野缺损的老年白人女性中，33.3%的频发跌倒可归因于视野缺损。
双眼视野缺损的女性未来频发跌倒的风险更高。筛查双眼视野缺损可能识别出跌倒高危个体。
