Glynn R J, Seddon J M, Krug J H, Sahagian C R, Chiavelli M E, Campion E W
Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.
Arch Ophthalmol. 1991 Feb;109(2):205-10. doi: 10.1001/archopht.1991.01080020051041.
We analyzed the determinants of serious falls among 489 ambulatory elders aged 65 years and older who received a comprehensive examination at a glaucoma consultation service. For the previous year, at least one fall requiring medical attention or restricted activity was reported by 9.6% (95% confidence interval [CI], 7.0% to 12.2%) of participants. Using logistic regression to adjust for potential confounding variables, the greatest single risk factor for falls was the use of nonmiotic topical eye medications (odds ratio [OR], 5.4; 95% Cl, 1.8 to 16.4). Additional risk factors for falls were female sex (OR, 2.3; 95% Cl, 1.1 to 4.7) and use of cardiac medications (OR, 2.5; 95% Cl, 1.1 to 5.6). Three other characteristics were also associated with the risk of falls: use of miotic eye medications (OR, 3.2; 95% Cl, 1.0 to 10.1); visual field impairment of 40% or greater (OR, 3.0; 95% Cl, 0.94 to 9.8); and use of sedatives (OR, 2.4; 95% Cl, 0.89 to 6.7). These findings suggest that ocular and systemic medications are the major predictors of falls even in this elderly population seeking ophthalmologic care for glaucoma. Medications appear to pose a greater risk for falls than even major visual impairment.
我们分析了489名65岁及以上在青光眼咨询服务中心接受全面检查的门诊老年人中严重跌倒的决定因素。在过去一年中，9.6%（95%置信区间[CI]，7.0%至12.2%）的参与者报告至少发生过一次需要医疗关注或导致活动受限的跌倒。使用逻辑回归对潜在混杂变量进行调整后，跌倒的最大单一风险因素是使用非缩瞳局部眼用药物（比值比[OR]，5.4；95%CI，1.8至16.4）。跌倒的其他风险因素包括女性（OR，2.3；95%CI，1.1至4.7）和使用心脏药物（OR，2.5；95%CI，1.1至5.6）。还有其他三个特征也与跌倒风险相关：使用缩瞳眼用药物（OR，3.2；95%CI，1.0至10.1）；视野损害达40%或更高（OR，3.0；95%CI，0.94至9.8）；以及使用镇静剂（OR，2.4；95%CI，0.89至6.7）。这些发现表明，即使在这群因青光眼寻求眼科护理的老年人群中，眼部和全身用药也是跌倒的主要预测因素。药物似乎比严重视力损害带来的跌倒风险更大。
