Otorhinolaryngology, Shinseikai Toyama Hospital, Imizu, Japan.
Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan.
PLoS One. 2024 Apr 1;19(4):e0301377. doi: 10.1371/journal.pone.0301377. eCollection 2024.
Falls in older adults are a significant public health concern, and age-related macular degeneration (AMD) and glaucoma have been identified as potential visual risk factors. This study was designed to assess equilibrium function, fall risk, and fall-related self-efficacy (an individual's belief in their capacity to act in ways necessary to reach specific goals) in patients with AMD and glaucoma.
This observational study was performed at the Otorhinolaryngology Department of Shinseikai Toyama Hospital. The cohort comprised 60 participants (AMD; n = 30; median age, 76.0 years; and glaucoma; n = 30; median age, 64.5 years). Visual acuity and visual fields were assessed using the decimal best-corrected visual acuity and Humphrey visual field tests, respectively. The evaluation metrics included pathological eye movement analysis, bedside head impulse test, single-leg upright test, eye-tracking test, optokinetic nystagmus, and posturography. Furthermore, we administered questionnaires for fall risk determinants including the Dizziness Handicap Inventory, Activities-Specific Balance Confidence Scale, Falls Efficacy Scale-International, and Hospital Anxiety and Depression Scale. The collected data were analyzed using descriptive statistics, and Spearman's correlation analysis was employed to examine the interrelations among the equilibrium function, fall risk, and other pertinent variables.
Most participants exhibited standard outcomes in equilibrium function evaluations. Visual acuity and field deficits had a minimal impact on subjective dizziness manifestations, degree of disability, and fall-related self-efficacy. Both groups predominantly showed high self-efficacy. No significant correlation was observed between visual acuity or field deficits and body equilibrium function or fall risk. However, greater peripheral visual field impairment was associated with a tendency for sensory reweighting from visual to somatosensory.
Self-efficacy was higher and fall risk was relatively lower among patients with mild-to-moderate visual impairment, with a tendency for sensory reweighting from visual to somatosensory in those with greater peripheral visual field impairment. Further studies are required to validate these findings.
老年人跌倒已成为一个重大的公共卫生问题，年龄相关性黄斑变性（AMD）和青光眼已被确定为潜在的视觉危险因素。本研究旨在评估 AMD 和青光眼患者的平衡功能、跌倒风险和与跌倒相关的自我效能（个体对自身实现特定目标所需行动能力的信念）。
本观察性研究在新潟信愛会医院耳鼻喉科进行。该队列包括 60 名参与者（AMD 组 30 名，中位年龄 76.0 岁；青光眼组 30 名，中位年龄 64.5 岁）。使用十进制最佳矫正视力和 Humphrey 视野测试分别评估视力和视野。评估指标包括病理性眼球运动分析、床边头部脉冲试验、单腿直立试验、眼球追踪试验、视动性眼球震颤和姿势描记术。此外，我们还使用头晕障碍问卷、活动特异性平衡信心量表、跌倒效能量表-国际版和医院焦虑抑郁量表评估跌倒风险决定因素。使用描述性统计分析收集的数据，并进行 Spearman 相关分析以检查平衡功能、跌倒风险和其他相关变量之间的相互关系。
大多数参与者的平衡功能评估结果正常。视力和视野缺陷对主观头晕表现、残疾程度和与跌倒相关的自我效能影响较小。两个组的自我效能都较高。视力或视野缺陷与身体平衡功能或跌倒风险之间无显著相关性。然而，较大的周边视野损害与从视觉到躯体感觉的感觉重新加权倾向相关。
在轻度至中度视力障碍患者中，自我效能较高，跌倒风险相对较低，且周边视野损害较大的患者有从视觉到躯体感觉的感觉重新加权倾向。需要进一步的研究来验证这些发现。
