Chatterjee Sayan K, Talebi Ramin, Kitayama Ken, Young Andrew G, Yu Fei, Tseng Victoria L, Coleman Anne L
David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California.
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania; Department of Ophthalmology, Stein and Doheny Eye Institutes, University of California, Los Angeles, Los Angeles, California.
Ophthalmol Glaucoma. 2025 Mar-Apr;8(2):167-174. doi: 10.1016/j.ogla.2024.10.002. Epub 2024 Oct 16.
To examine the association between glaucoma severity and hip fractures in older adults.
Retrospective cross-sectional study.
California (CA) Medicare beneficiaries in 2019 with Parts A & B coverage.
Multivariable logistic regression was used to analyze the association between glaucoma severity (mild, moderate, and severe vs. no glaucoma) and hip fracture, after adjusting for age, sex, race and ethnicity, and Charlson Comorbidity Index score. A subgroup analysis was performed only in individuals with glaucoma to examine the odds of hip fracture for those with moderate and severe glaucoma compared to those with mild glaucoma.
The variations in the odds of hip fractures for patients with and without glaucoma and for patients with moderate and severe glaucoma compared to those with mild glaucoma.
Of the 2 717 346 beneficiaries in the study population, 220 662 (8.1%) had glaucoma. In multivariable regression analysis, those with mild (odds ratio [OR]: 0.83; 95% confidence interval [CI]: 0.78-0.88) and moderate glaucoma (OR: 0.88; 95% CI: 0.84-0.92) had reduced odds of hip fracture compared with those with no glaucoma. There was no statistically significant association between severe vs. no glaucoma and hip fracture (OR: 0.96; 95% CI: 0.91-1.02). Among individuals with glaucoma, the odds of hip fracture were higher for those with severe glaucoma (OR: 1.17; 95% CI: 1.08-1.27), compared with those with mild glaucoma.
In the CA Medicare population, the presence of glaucoma was associated with decreased likelihood of hip fracture. However, in those with glaucoma, increased glaucoma severity was associated with an increased likelihood of hip fracture. Potential mediating mechanisms requiring further study include fear of falls and physical inactivity in patients with glaucoma.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
研究老年人青光眼严重程度与髋部骨折之间的关联。
回顾性横断面研究。
2019年加利福尼亚州（CA）享受医疗保险A部分和B部分覆盖的老年医保受益人。
在调整年龄、性别、种族和民族以及查尔森合并症指数评分后，使用多变量逻辑回归分析青光眼严重程度（轻度、中度和重度与无青光眼）与髋部骨折之间的关联。仅在青光眼患者中进行亚组分析，以研究中度和重度青光眼患者与轻度青光眼患者相比发生髋部骨折的几率。
有青光眼和无青光眼患者以及中度和重度青光眼患者与轻度青光眼患者相比髋部骨折几率的差异。
在研究人群的2717346名受益人中，220662人（8.1%）患有青光眼。在多变量回归分析中，与无青光眼者相比，轻度青光眼患者（比值比[OR]：0.——83；95%置信区间[CI]：0.78 - 0.88）和中度青光眼患者（OR：0.88；95% CI：0.84 - 0.92）发生髋部骨折的几率降低。重度青光眼与无青光眼相比，与髋部骨折无统计学显著关联（OR：0.96；95% CI：0.91 - 1.02）。在青光眼患者中，与轻度青光眼患者相比，重度青光眼患者发生髋部骨折的几率更高（OR：1.17；95% CI：1.08 - 1.27）。
在加利福尼亚州老年医保人群中，青光眼的存在与髋部骨折可能性降低有关。然而，在青光眼患者中，青光眼严重程度增加与髋部骨折可能性增加有关。需要进一步研究的潜在中介机制包括青光眼患者对跌倒的恐惧和身体活动不足。
在本文末尾的脚注和披露中可能会找到专有或商业披露信息。
