Freeman Ellen E, Broman Aimee T, Turano Kathleen A, West Sheila K
Department of Ophthalmology, Johns Hopkins University, Baltimore, Maryland, USA.
Invest Ophthalmol Vis Sci. 2008 Dec;49(12):5257-63. doi: 10.1167/iovs.07-1106. Epub 2008 Aug 21.
The aim of this study was to identify the visual factors associated with various levels of balance ability in a population-based study of older adults.
Data for this analysis came from the third round of the Salisbury Eye Evaluation population-based cohort study (1505 individuals). Measures of visual function including acuity, contrast sensitivity, visual fields, and motion detection were obtained. Balance was assessed by determining if participants could complete a series of timed stands designed to increase in difficulty. The outcome was an unsuccessful stand. Analyses were performed using logistic regression with generalized estimating equations with stand type as an indicator variable.
In a model containing all vision variables, those with worse motion-detection threshold were more likely to have an unsuccessful tandem stand (odds ratio [OR] = 1.56, 95% CI: 1.13-2.15) and soleo stand (on one foot of choice with eyes open and arms out; OR = 3.08, 95% CI: 1.57-6.06) while those with worse visual field were more likely to have an unsuccessful tandem stand (OR = 1.22, 95% CI: 1.08-1.38) after adjustment. Furthermore, the relationship between motion-detection threshold and an unsuccessful stand was stronger for the most difficult stand on one foot (the soleo stand) (P = 0.02).
Problems with balance in older adults may be due, in part, to decreased ability to detect small movements and/or visual field reduction.
本研究旨在通过一项针对老年人的基于人群的研究，确定与不同平衡能力水平相关的视觉因素。
该分析的数据来自索尔兹伯里眼评估基于人群的队列研究的第三轮（1505名个体）。获取了包括视力、对比敏感度、视野和运动检测在内的视觉功能测量数据。通过确定参与者是否能够完成一系列难度逐渐增加的定时站立来评估平衡能力。结果是站立失败。使用逻辑回归和广义估计方程进行分析，将站立类型作为指示变量。
在包含所有视觉变量的模型中，运动检测阈值较差的人更有可能在串联站立（优势比[OR]=1.56，95%可信区间：1.13 - 2.15）和单脚站立（单脚选择站立，睁眼并伸出双臂；OR = 3.08，95%可信区间：1.57 - 6.06）时失败，而视野较差的人在调整后更有可能在串联站立时失败（OR = 1.22，95%可信区间：1.08 - 1.38）。此外，运动检测阈值与站立失败之间的关系在最困难的单脚站立（单脚站立）中更强（P = 0.02）。
老年人的平衡问题可能部分归因于检测微小运动的能力下降和/或视野缩小。
