Freeman Ellen E, Muñoz Beatriz, Rubin Gary, West Sheila K
Department of Ophthalmology, Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
Invest Ophthalmol Vis Sci. 2007 Oct;48(10):4445-50. doi: 10.1167/iovs.07-0326.
Falls are a serious and preventable problem in older adults. Impaired vision has been linked to risk of falls; however, the impact of deficits in specific components of vision on the risk of falls is not well known.
Data on falls for up to 20 months were provided by 2375 individuals participating in the Salisbury Eye Evaluation (SEE). Visual acuity, contrast sensitivity, visual field, and stereoacuity were tested by using standard measures. To aid in the assessment, each participant recorded falls on a calendar that was sent every month to the SEE clinic. beta-Binomial regression analysis was used.
Worse visual field scores were associated with the risk of falling (OR = 1.08 for a 10-point loss of points, 95% CI 1.03-1.13). When both central (</= 20 degrees radius) and peripheral visual fields were in the same model, only the peripheral visual field was associated with falls (OR = 1.06, 95% CI 1.01-1.10). Visual acuity, contrast sensitivity, and stereoacuity were not associated with falls after adjustment for demographic and health variables.
Visual field loss is the primary vision component that increases the risk of falls. This finding highlights the importance of visual field deficits in the risk of falls and supports other findings on decrements in mobility and increased risk of bumping with worsening visual field function. Persons with visual field loss may benefit from mobility training to reduce the risk of falling.
跌倒在老年人中是一个严重且可预防的问题。视力受损与跌倒风险相关；然而，视力特定组成部分的缺陷对跌倒风险的影响尚不清楚。
2375名参与索尔兹伯里眼评估（SEE）的个体提供了长达20个月的跌倒数据。使用标准测量方法测试视力、对比敏感度、视野和立体视敏度。为了辅助评估，每位参与者在每月发送至SEE诊所的日历上记录跌倒情况。采用β-二项回归分析。
较差的视野评分与跌倒风险相关（每降低10分，比值比[OR]=1.08，95%置信区间[CI]为1.03 - 1.13）。当中心视野（半径≤20度）和周边视野在同一模型中时，仅周边视野与跌倒相关（OR = 1.06，95% CI为1.01 - 1.10）。在对人口统计学和健康变量进行调整后，视力、对比敏感度和立体视敏度与跌倒无关。
视野丧失是增加跌倒风险的主要视力组成部分。这一发现凸显了视野缺陷在跌倒风险中的重要性，并支持了关于随着视野功能恶化，行动能力下降和碰撞风险增加的其他研究结果。视野丧失者可能从移动训练中受益，以降低跌倒风险。
