Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich, Zurich, Switzerland.
Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland.
J Am Med Dir Assoc. 2024 May;25(5):789-795.e2. doi: 10.1016/j.jamda.2024.03.005. Epub 2024 Apr 16.
Although aging has a strong impact on visual acuity (VA) and falls, their interaction is understudied in generally healthy older adults. This study aimed to examine if and to what extent baseline VA is associated with an increased risk of all and injurious falls over 3 years in generally healthy community-dwelling older adults.
Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial.
Multicenter trial with 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin (Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including 2157 community-dwelling adults aged 70 years and older without any major health events in the 5 years prior to enrollment, sufficient mobility, and good cognitive status.
The numbers of all and injurious falls were recorded prospectively by diary and in-person assessment every 3 months. Decreased VA at baseline was defined as better-eye VA lower than 1.0. We applied negative binomial regression models for all and injurious falls, adjusted for age, sex, prior falls, treatment allocation, study site, baseline body mass index, and use of walking aids.
Among the 2131 participants included in this analysis (mean age: 74.9 years, 61.7% were women, 82.6% at least moderately physically active), 1464 (68.7%) had decreased VA. Overall, 3290 falls including 2116 injurious falls were recorded over 3 years. Decreased VA at baseline was associated with a 22% increased incidence rate of all falls [adjusted incidence rate ratio (aIRR) = 1.22, 95% CI 1.07, 1.38, P = .003] and 20% increased incidence rate of injurious falls (aIRR = 1.20, 95% CI 1.05, 1.37, P = .007).
Our findings suggest that decreased VA is an independent predictor of an about 20% increased risk of all and injurious falls, highlighting the importance of regular eye examinations and VA measurements for fall prevention, even in generally healthy and active older adults.
尽管衰老对视力（VA）和跌倒有很强的影响，但它们在一般健康的老年人中的相互作用研究还很不足。本研究旨在探讨基线 VA 是否以及在何种程度上与一般健康的社区居住老年人在 3 年内所有和伤害性跌倒的风险增加相关。
DO-HEALTH 的观察性分析，一项双盲、随机对照试验。
多中心试验，包括 7 个欧洲中心：苏黎世、巴塞尔、日内瓦（瑞士）、柏林（德国）、因斯布鲁克（奥地利）、图卢兹（法国）和科英布拉（葡萄牙），共有 2157 名社区居住的 70 岁及以上老年人，在入组前 5 年内没有任何重大健康事件，有足够的活动能力和良好的认知状态。
所有和伤害性跌倒的次数均通过日记和每 3 个月一次的亲自评估进行前瞻性记录。基线时 VA 下降定义为最佳眼 VA 低于 1.0。我们应用负二项回归模型分析所有和伤害性跌倒，调整因素包括年龄、性别、既往跌倒、治疗分配、研究地点、基线体重指数和助行器使用情况。
在本分析中纳入的 2131 名参与者（平均年龄：74.9 岁，61.7%为女性，82.6%至少为中度体力活动）中，有 1464 名（68.7%）有 VA 下降。总体而言，在 3 年内记录了 3290 次跌倒，包括 2116 次伤害性跌倒。基线时 VA 下降与所有跌倒的发生率增加 22%相关[校正发病率比（aIRR）=1.22，95%CI 1.07，1.38，P=.003]和伤害性跌倒的发生率增加 20%相关（aIRR=1.20，95%CI 1.05，1.37，P=.007）。
我们的研究结果表明，VA 下降是所有和伤害性跌倒风险增加约 20%的独立预测因素，强调了定期进行眼部检查和 VA 测量对于预防跌倒的重要性，即使是在一般健康和活跃的老年人中也是如此。
