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Ekemiri K, Ekemiri C, Ezinne N, Virginia V, Okoendo O, Seemongal-Dass R, Van Staden D, Abraham C. Global burden of fall and associated factors among individual with low vision: A systematic-review and meta-analysis. PLoS One 2024; 19:e0302428. [PMID: 39047020 PMCID: PMC11268632 DOI: 10.1371/journal.pone.0302428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/04/2024] [Indexed: 07/27/2024] Open
Abstract
INTRODUCTION Low vision has a significant global health problem that impacts the personal, economical, psychological, and social life of an individual. Each year around 684 000 individuals die from falls, 80% of these deaths occur are in low- and middle-income countries. The risk of falling significantly increases with visual impairment. This review aimed to determine the global pooled prevalence of fall and associated factors among individuals with low vision. METHODS AND MATERIALS Systematic search of published studies done on PubMed, EMBASE, MEDLINE, Cochrane, Scopus, Web of Science CINAHL and, Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to report the findings. Quality of studies was assessed using the modified Newcastle-Ottawa Scale (NOS). Meta-analysis was performed using a random-effects method using the STATA™ Version 14 software. RESULT Thirty-five (35) studies from different regions involving 175,297 participants included in this meta-analysis. The overall pooled global prevalence fall among individual with low vision was17.7% (95% CI: 16.4-18.9) whereas the highest prevalence was 35.5%; (95% CI: 28.4-42.5) in Australia and the lowest was 19.7%; (95% CI: 7.6-31.8) seen in South America. Fear of falling (OR: 0.16(95%CI 0.09-0.30), and severity of visual impairment (OR: 0.27(95%CI (0.18-0.39) increases the odds of falling. CONCLUSION As one cause of accidental death, the prevalence of falls among individuals with low vision is high. Fear of falling and severity of falling increases the odds of falling. Different stakeholders should give due attention and plan effective strategies to reduce the fall among this population.
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Affiliation(s)
- Kingsley Ekemiri
- Department of Optometry, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Tunapuna, Trinidad and Tobago
| | - Chioma Ekemiri
- Department of Health Promotion, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Tunapuna, Trinidad and Tobago
| | - Ngozika Ezinne
- Department of Optometry, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Tunapuna, Trinidad and Tobago
| | - Victor Virginia
- School of Nursing, Faculty of Medical Sciences, The University of the West Indies, St Augustine Campus, Tunapuna, Trinidad and Tobago
| | - Osaze Okoendo
- Department of Optometry, Courts Optical, Couva, Trinidad and Tobago
| | - Robin Seemongal-Dass
- Ophthalmology Unit, Faculty of Medical Sciences, The University of the West Indies, Tunapuna, Trinidad and Tobago
| | - Diane Van Staden
- Faculty of Health Sciences and Social Development, University of British Columbia, Tunapuna, South Africa
| | - Carl Abraham
- Department of Optometry and Vision Sciences, University of the Cape Coast, Coast, Ghana
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Purola P, Koskinen S, Uusitalo H. Nationwide and regional trends in distance and near visual acuities during 2000-2017 in Finland. Acta Ophthalmol 2023. [PMID: 37772430 DOI: 10.1111/aos.15784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/30/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023]
Abstract
PURPOSE To evaluate time trends in distance and near vision at the national and regional levels during 2000-2017 in Finland. METHODS We used three cross-sectional, nationwide health examination surveys representing the Finnish adult population aged 30 years or older in 2000, 2011 and 2017. Bilateral, habitual distance and near visual acuity (VA) were measured in all three surveys. RESULTS The prevalence of good distance vision (VA ≥ 1.0) increased from 76.7% to 81.3% during 2000-2017 while the prevalence of weak or worse distance vision (VA ≤ 0.5) decreased from 7.6% to 3.7%. The improvements were largest among those aged 85 years and older: the prevalence of distance VA ≤ 0.5 decreased from 71.8% to 28.3%. Near vision showed improvement to a lesser extent in the total population; nevertheless, among those aged 85 years and older the prevalence of weak or worse near vision (VA ≤ 0.5) decreased from 62.3% to 27.1%. A similar positive time trend was observed in all main regions of Finland, and differences between urban and rural regions were small. CONCLUSION During the past two decades, the overall vision level has improved among the adult population. This is explained mostly by a positive shift from lower to higher vision levels among older age groups, indicating that people live longer with good or adequate vision. This positive trend showed remarkable similarity throughout different regions in Finland, highlighting the importance of equal and accessible eye care throughout the country.
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Affiliation(s)
- Petri Purola
- Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Hannu Uusitalo
- Department of Ophthalmology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Register of Visual Impairment, Finnish Federation of the Visually Impaired, Helsinki, Finland
- Tays Eye Center, Tampere University Hospital, Tampere, Finland
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Lundälv J, Thodelius C. Risk of Injury Events in Patients With Visual Impairments: A Swedish Survey Study Among Hospital Social Workers. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2021. [DOI: 10.1177/0145482x211046666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: People with visual impairments (those who are blind or have low vision) are exposed to risks in everyday life, especially injury risks. This study aimed to examine experiences and practical knowledge among hospital social workers in Sweden concerning meetings with patients with visual impairments who have been affected by injury events in residential environments. Methods: Swedish hospital social workers specializing in patients with visual impairments ( n=30) answered a questionnaire comprising 14 questions. Both fixed and open-ended questions were included, allowing an analysis of both comparable numeric data and subjectively perceived experiences and opinions. Results: A majority of the respondents had met patients who had been injured in the residential setting; the most common injury mechanism reported was tripping or falling on the stairs, or accidentally stumbling into furniture. The hospital social workers acknowledged that they could work more preventively in their professional role by encouraging patients to use orientation and mobility devices such as long canes, increasing collaboration with other professions, and conducting home visits to enable trustful dialogues with both patients and relatives. Discussion: According to these specialized hospital social workers, the provision of education and information to patients with visual impairments could potentially prevent future injury. However, in order to achieve this, there is a need to first enable a trustful dialogue between social workers and patients. Implications for practitioners: This study provides a better understanding of the importance of trustful dialogue between hospital social workers and patients with visual impairments, from the point of view injury prevention. It also offers a summary of the knowledge of hospital social workers about risks and injury events in residential settings for patients with visual impairments.
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Affiliation(s)
- Jörgen Lundälv
- Department of Social Work, University of Gothenburg, Gothenburg, Sweden
| | - Charlotta Thodelius
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
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Han SY, Chang Y, Shin H, Choi CY, Ryu S. Visual acuity and risk of overall, injury-related, and cardiovascular mortality: the Kangbuk Samsung Health Study. Eur J Prev Cardiol 2021; 29:904-912. [PMID: 33615358 DOI: 10.1093/eurjpc/zwab025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 01/23/2021] [Accepted: 02/07/2021] [Indexed: 01/26/2023]
Abstract
AIMS The associations of visual impairment (VI) with cardio-metabolic risk factors have been reported but its association with cardiovascular mortality remains uncertain. Therefore, we evaluated the association of visual acuity (VA) with overall, injury-related, and cardiovascular mortality. METHODS AND RESULTS A cohort study was performed in 580 746 Korean adults (average age, 39.7 years) who were followed for a median of 8.1 years (maximum, 16 years). Presenting VA was measured by the Early Treatment Diabetic Retinopathy Study (ETDRS) chart. Visual acuity in the better vision eye was categorized as normal vision (≥0.8), lowered vision (0.5-0.8), mild visual impairment (VI) (0.3-0.5), or moderate to severe VI (<0.3). Vital status and cause of death were ascertained through linkage to national death records. During 4 632 892.2 person-years of follow-up, 6585 overall deaths, 974 cardiovascular deaths, and 1163 injury-related deaths were identified. After adjustment for possible confounders, the multivariable-adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) for overall mortality among participants with lowered vision, minimal VI, and moderate to severe VI were 1.21 (1.13-1.29), 1.26 (1.15-1.37), and 1.54 (1.40-1.68), respectively, compared with those with normal vision. The corresponding HRs (95% CIs) for injury-related mortality were 1.12 (0.96-1.32), 0.98 (0.76-1.26), and 1.36 (1.04-1.79), respectively, and the corresponding HRs (95% CIs) for cardiovascular mortality were 1.32 (1.12-1.57), 1.43 (1.15-1.77), and 2.41 (1.94-2.99). CONCLUSION In this large cohort of young and middle-aged individuals, VI was associated with increased risk of mortality especially due to cardiovascular disease.
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Affiliation(s)
- So Young Han
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hocheol Shin
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Family Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Chul Young Choi
- Department of Ophthalmology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul 03181, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Total Healthcare Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Clinical Research Design & Evaluation, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
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Alimaw YA, Hussen MS, Tefera TK, Yibekal BT. Knowledge about cataract and associated factors among adults in Gondar town, northwest Ethiopia. PLoS One 2019; 14:e0215809. [PMID: 31013319 PMCID: PMC6478322 DOI: 10.1371/journal.pone.0215809] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 04/09/2019] [Indexed: 11/19/2022] Open
Abstract
Purpose The aim of this study was to assess knowledge regarding cataract and associated factors among adults in Gondar town Northwest Ethiopia. Methods A community-based cross-sectional study was conducted on 836 adults age ≥18years, using multi-stage systematic random sampling technique, in Gondar town Northwest Ethiopia from April 15-May 7, 2017. Data were collected using pre-tested structured questionnaires through face to face interview. The collected data was entered to Epi info version 7 and analyzed using SPSS version 20. Binary logistic regression was used to identify associated factors. Those variables with p-value <0.05 and confidence interval ≠ 1 in multivariable logistic regression were considered as statistically significant factors for knowledge regarding cataract. Result Among 845 eligible adults, 98.9% (836) of them were fully participated. The median age of participants was 28 years with an interquartile range of 17 years. Of the total participants, 67.2% (562) of them had awareness about cataract [95% CI, 63.8–70.2]. Among 562 participants, 61.7% of them had good knowledge about cataract [95% CI, 57.5–66.00]. It was also found that higher level of education [AOR = 2.86, 95%CI: 1.37–5.96], higher family monthly income [AOR = 1.92, 95%CI: 1.03–3.57], having previous eye examination [AOR = 1.53, 95% CI: 1.02–2.31] and positive family history of cataract [AOR = 1.76, 95%CI: 1.03–3.01] were positively associated with good knowledge. Conclusion Significant portion of the participants had good knowledge about cataract, which was positively associated with higher level of education, higher family monthly income, presence of previous eye examination and positive family history of cataract. However, significant knowledge gap regarding the risk factors and prevention strategies was recognized. Hence, it might be logical to pay special attention in prospering knowledge on how to prevent the occurrence of the disease.
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Affiliation(s)
- Yezinsh Addis Alimaw
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Mohammed Seid Hussen
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Tsehay Kassa Tefera
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
| | - Betelhem Temesgen Yibekal
- Department of Optometry, School of Medicine, College of Medicine and Health Science, University of Gondar, Gondar Town, Ethiopia
- * E-mail:
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Sahraravand A, Haavisto AK, Holopainen JM, Leivo T. Ocular trauma in the Finnish elderly - Helsinki Ocular Trauma Study. Acta Ophthalmol 2018; 96:616-622. [PMID: 29659145 DOI: 10.1111/aos.13714] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Accepted: 01/05/2018] [Indexed: 12/18/2022]
Abstract
PURPOSE To describe epidemiology, causes, treatments and outcomes of all ocular injuries in southern Finland among people aged 61 and older. METHODS All new ocular trauma patients, admitted to the Helsinki University Eye Hospital, during 1 year in 2011-2012. The data were from hospital records and prospectively from patient questionnaires. The follow-up time was 3 months. RESULTS The incidence for ocular injuries among the elderly was 38/100 000/year. From 118 patients 69% were men. The mean age was 70.9 years old (median 67). The hospitalization rate was 14%. Injury types were minor traumas (48%), contusions (22%), chemical injuries (10%), eyelid wounds (8%), open globe injuries (OGI; 7%) and orbital fractures (5%). The injuries occurred at home (58%), institutions (12%) and in other public places (12%). The main causes of ocular injury were falls (22%), sticks (19%), superficial foreign bodies (18%) and chemicals (12%). All OGI and 88% of contusions needed a lifelong follow-up. A permanent visual or functional impairment occurred in 15 (13%) patients. Of these 53% were OGI, 40% contusions and 7% chemical injuries. The causes of permanent injuries were falls (seven cases, 47%), work tools, sports equipment, sticks, chemicals and eyeglasses. The incidence for legal blindness was 2.3/100 000. CONCLUSION Minor trauma was the most frequent type, and home was the location of the most occurred eye injuries. Falls were the most frequent and serious cause, but behavioural causes were not significant. Preventive measures should be directed towards the main identified causes and risk factors of the eye injuries in the elderly.
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Affiliation(s)
- Ahmad Sahraravand
- Department of Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Anna-Kaisa Haavisto
- Department of Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Juha M. Holopainen
- Department of Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
| | - Tiina Leivo
- Department of Ophthalmology; University of Helsinki and Helsinki University Hospital; Helsinki Finland
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The Association between Age-Related Macular Degeneration and the Risk of Mortality. BIOMED RESEARCH INTERNATIONAL 2017; 2017:3489603. [PMID: 28607930 PMCID: PMC5451765 DOI: 10.1155/2017/3489603] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/23/2017] [Accepted: 04/27/2017] [Indexed: 12/22/2022]
Abstract
Studies have investigated the association between age-related macular degeneration (AMD) and subsequent risks of mortality, but results have been equivocal. We conducted a comprehensive analysis of prospective cohort studies to assess the association of AMD and the risk of mortality in the general population. We searched PubMed and EMBASE for trials published from 1980 to 2016. We included 11 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and mortality, involving 57,069 participants. In a random-effects model, the adjusted RR (95% confidence interval) associated with AMD was 1.09 (1.02-1.17) for all-cause mortality. Findings from this research provide support that persons with AMD had a higher subsequent risk of mortality than persons without AMD.
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Starkoff BE, Lenz EK, Lieberman LJ, Foley J, Too D. Physical activity patterns of adults with visual impairments. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2017. [DOI: 10.1177/0264619617691080] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined physical activity (PA) patterns in adults with visual impairments (VI) using the International Physical Activity Questionnaire–Short Form, assessing moderate physical activity (MPA), vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MVPA). A total of 115 individuals (age: 36.1 ± 13.9 years, body mass index [BMI]: 28 ± 6.9 kg/m2) with VI completed the study. One-way analyses of variance (ANOVAs) were performed on VI (B1, B2, B3, and B4), collapsed VI (blind [B1] vs VI [B2–B4]), gender, and BMI across PA. A 2 × 4 factor ANOVA examined the impact of gender and BMI on PA. B2 walked more than B1 ( p = .021) and walk time was less in B1 ( p = .021) than VI. Males accumulated more MPA ( p = .002) and MVPA ( p = .008), and a greater percentage of males acquired recommended PA ( p = .008). Overweight participants acquired more VPA than normal-weight participants ( p = .020). A main effect for gender ( p = .000) and interaction between gender and BMI ( p = .049) were identified with MPA. Differences in PA based on VI may be a result of barriers specific to B1, suggesting the need for education in this population.
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Affiliation(s)
| | | | | | | | - Danny Too
- The College at Brockport, State University of New York, USA
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Clinical Risk Factors for Head Impact During Falls in Older Adults: A Prospective Cohort Study in Long-Term Care. J Head Trauma Rehabil 2017; 32:168-177. [DOI: 10.1097/htr.0000000000000257] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Melillo P, Orrico A, Chirico F, Pecchia L, Rossi S, Testa F, Simonelli F. Identifying fallers among ophthalmic patients using classification tree methodology. PLoS One 2017; 12:e0174083. [PMID: 28334052 PMCID: PMC5363841 DOI: 10.1371/journal.pone.0174083] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Accepted: 03/04/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To develop and validate a tool aiming to support ophthalmologists in identifying, during routine ophthalmologic visits, patients at higher risk of falling in the following year. METHODS A group of 141 subjects (age: 73.2 ± 11.4 years), recruited at our Eye Clinic, underwent a baseline ophthalmic examination and a standardized questionnaire, including lifestyles, general health, social engagement and eyesight problems. Moreover, visual disability was assessed by the Activity of Daily Vision Scale (ADVS). The subjects were followed up for 12 months in order to record prospective falls. A subject who reported at least one fall within one year from the baseline assessment was considered as faller, otherwise as non-faller. Different tree-based algorithms (i.e., C4.5, AdaBoost and Random Forests) were used to develop automatic classifiers and their performances were evaluated by the cross-validation approach. RESULTS Over the follow-up, 25 falls were referred by 13 patients. The logistic regression analysis showed the following variables as significant predictors of prospective falls: pseudophakia and use of prescribed eyeglasses as protective factors, recent worsening of visual acuity as risk factor. Random Forest ranked best corrected visual acuity, number of sleeping hours and job type as the most important features. Finally, AdaBoost enabled the identification of subjects at higher risk of falling in the following 12 months with a sensitivity rate of 69.2% and a specificity rate of 76.6%. CONCLUSIONS The current study proposes a novel method, based on classification trees applied to self-reported factors and health information assessed by a standardized questionnaire during ophthalmological visits, to identify ophthalmic patients at higher risk of falling in the following 12 months. The findings of the current study pave the way to the validation of the proposed novel tool for fall risk screening on a larger cohort of patients with visual impairment referred to eye clinics.
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Affiliation(s)
- Paolo Melillo
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
- * E-mail:
| | - Ada Orrico
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Franco Chirico
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Leandro Pecchia
- School of Engineering, University of Warwick, Coventry, United Kingdom
| | - Settimio Rossi
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Testa
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Francesca Simonelli
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
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Keay L, Dillon L, Clemson L, Tiedemann A, Sherrington C, McCluskey P, Ramulu P, Jan S, Rogers K, Martin J, Tinsley F, Jakobsen KB, Ivers RQ. PrevenTing Falls in a high-risk, vision-impaired population through specialist ORientation and Mobility services: protocol for the PlaTFORM randomised trial. Inj Prev 2017; 24:459-466. [DOI: 10.1136/injuryprev-2016-042301] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 01/09/2017] [Accepted: 01/18/2017] [Indexed: 11/04/2022]
Abstract
BackgroundOlder people with vision impairment have significant ongoing morbidity, including risk of falls, but are neglected in fall prevention programmes. PlaTFORM is a pragmatic evaluation of the Lifestyle-integrated Functional Exercise fall prevention programme for older people with vision impairment or blindness (v-LiFE). Implementation and scalability issues will also be investigated.MethodsPlaTFORM is a single-blinded, randomised trial designed to evaluate the v-LiFE programme compared with usual care. Primary outcomes are fall rate over 12 months, measured using prospective monthly fall calendars, and function and participation assessed by the Late-Life Function and Disability Instrument (Late-Life FDI) Function component. The secondary outcome is rate of falls requiring medical care. Activity-normalised fall rate will be estimated using accelerometer-measured physical activity data. EuroQol 5-dimension 5-level questionnaire will measure quality of life and impact of falls. Health record linkage will estimate resource use associated with falls. v-LiFE cost-effectiveness will be determined compared with usual care. 500 participants (250 per group) can provide 90% power to detect a significant between-group difference in fall rates; 588 will be recruited to allow for drop-out. Falls per person-year and Late-Life FDI will be compared between groups.DiscussionPlaTFORM will determine if falls can be prevented among older people with vision loss through a home-based exercise programme. v-LiFE embeds balance and strength training within everyday activities with the aim of preventing falls. The study will also determine whether the programme can be effectively delivered by personnel who provide Orientation and Mobility training for people with vision impairment.Trial registration numberACTRN12616001186448p.
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Relation between Age-Related Macular Degeneration and Cardiovascular Events and Mortality: A Systematic Review and Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2016; 2016:8212063. [PMID: 28070519 PMCID: PMC5192308 DOI: 10.1155/2016/8212063] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 09/27/2016] [Accepted: 11/14/2016] [Indexed: 01/20/2023]
Abstract
Data on the association between age-related macular degeneration (AMD) and cardiovascular disease and mortality are conflicting. The purpose of this report is to conduct a systematic review to better understand the role of AMD as a risk factor for CVD events and mortality. We searched Medline (Ovid) and Embase (Ovid) for trials published from 1980 to 2015. We included 20 cohort studies that reported relative risks with 95% confidence intervals for the association of AMD and cardiovascular events and mortality, involving 29,964,334 participants. In a random-effects model, the adjusted RR (95% confidence interval [CI]) associated with AMD was 1.08 (1.00-1.117) for all-cause mortality (8 studies) and 1.18 (0.98-1.43) for cardiovascular disease mortality (5 studies). The pooled RR (95% CI) was 1.17 (0.94-1.45) for coronary heart disease (CHD; 3 studies) and 1.13 (0.93-1.36) for stroke (8 studies). Findings from this systematic review support that AMD is associated with increased risk of all-cause mortality. The evidence that AMD predicts incident CVD events or CVD mortality remains inclusive and warrants further study in the future.
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Visual acuity measured with a smartphone app is more accurate than Snellen testing by emergency department providers. Graefes Arch Clin Exp Ophthalmol 2016; 254:1175-80. [DOI: 10.1007/s00417-016-3291-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 02/02/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022] Open
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Graham V, Napier-Dovorany K. Multifactoral measures of fall risk in the visually impaired population: A pilot study. J Bodyw Mov Ther 2016; 20:104-109. [PMID: 26891644 DOI: 10.1016/j.jbmt.2015.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 05/24/2015] [Accepted: 06/19/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the feasibility of taking multiple measures of visual and physical function in adults with visual impairment. A second objective was to obtain preliminary data on risk for falls in this population. DESIGN Cohort feasibility study. SETTING University ambulatory patient care center and research center. PARTICIPANTS Convenience sample of community-dwelling men and women over age 18 with visual impairment (n = 12). Thirteen subjects were enrolled in the study; one was subsequently excluded due to self-reported cognitive decline at time of testing. Subjects were grouped by prospective fall incidence. INTERVENTIONS Verbal education. MAIN OUTCOME MEASURES Subjective measures of function; objective measures of visual and physical function. RESULTS Visually impaired adults can safely complete a battery of physical functions to predict fall risk. Recent onset of visual impairment was correlated with higher fall risk [-0.53 ± 0.22, p = 0.04]. CONCLUSIONS It is feasible for an interdisciplinary team to measure risk for falls in adults with a visual impairment. Further investigation is needed to identify predictors of falls in adults of all ages with visual impairment.
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Affiliation(s)
- Victoria Graham
- California State University Northridge, 18111 Nordhoff Street, California, 91330, USA.
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Soler V, Sourdet S, Balardy L, Abellan van Kan G, Brechemier D, Rougé-Bugat ME, Tavassoli N, Cassagne M, Malecaze F, Nourhashémi F, Vellas B. Visual Impairment Screening at the Geriatric Frailty Clinic for Assessment of Frailty and Prevention of Disability at the Gérontopôle. J Nutr Health Aging 2016; 20:870-877. [PMID: 27709237 DOI: 10.1007/s12603-015-0648-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate visual performance and factors associated with abnormal vision in patients screened for frailty at the Geriatric Frailty Clinic (GFC) for Assessment of Frailty and Prevention of Disability at Toulouse University Hospital. DESIGN Retrospective, observational cross-sectional, single-centre study. SETTING Institutional practice. PARTICIPANTS Patients were screened for frailty during a single-day hospital stay between October 2011 and October 2014 (n = 1648). MEASUREMENTS Collected medical records included sociodemographic data (including living environment and educational level), anthropometric data, and clinical data. The general evaluation included the patient's functional status using the Activities of Daily Living (ADL) scale and the Instrumental Activity of Daily Living (IADL) scale, the Mini-Mental State Examination (MMSE) for cognition testing, and the Short Physical Performance Battery (SPPB) for physical performance. We also examined Body Mass Index (BMI), the Mini-Nutritional Assessment (MNA), and the Hearing Handicap Inventory for the Elderly Screening (HHIE-S) tool. The ophthalmologic evaluation included assessing visual acuity using the Snellen decimal chart for distant vision, and the Parinaud chart for near vision. Patients were divided into groups based on normal distant/near vision (NDV and NNV groups) and abnormal distant/near vision (ADV and ANV groups). Abnormal distant or near vision was defined as visual acuity inferior to 20/40 or superior to a Parinaud score of 2, in at least one eye. Associations with frailty-associated factors were evaluated in both groups. RESULTS The mean age of the population was 82.6 ± 6.2 years. The gender distribution was 1,061 females (64.4%) and 587 males (35.6%). According to the Fried criteria, 619 patients (41.1%) were pre-frail and 771 (51.1%) were frail. Distant and near vision data were available for 1425 and 1426 patients, respectively. Distant vision was abnormal for 437 patients (30.7%). Near vision was abnormal for 199 patients (14%). Multiple regression analysis showed that abnormal distant vision as well as abnormal near vision were independently associated with greater age (P < 0.01), lower educational level (P < 0.05), lower performance on the MMSE (P < 0.001), and lower autonomy (P < 0.02), after controlling for age, gender, educational level, Fried criteria, and MMSE score. CONCLUSION The high prevalence of visual disorders observed in the study population and their association with lower autonomy and cognitive impairment emphasises the need for systematic screening of visual impairments in the elderly. Frailty was not found to be independently associated with abnormal vision.
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Affiliation(s)
- V Soler
- Vincent Soler, Retina Unit, Ophthalmology Department, Hôpital Pierre Paul Riquet, Place du Docteur Baylac, TSA 40031, 31059 TOULOUSE Cedex 9, France, Phone number: (+33)-5-61-77-71-74, Fax number: (+33)-5-34-55-74-71, Email address :
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Gopinath B, Liew G, Burlutsky G, Mitchell P. Age-related macular degeneration and risk of total and cause-specific mortality over 15 years. Maturitas 2015; 84:63-7. [PMID: 26596903 DOI: 10.1016/j.maturitas.2015.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 10/30/2015] [Accepted: 11/02/2015] [Indexed: 11/19/2022]
Abstract
OBJECTIVE We aimed to investigate the independent association between AMD and risk of ischemic heart disease (IHD), stroke, and cardiovascular (CVD) mortality, and all-cause mortality over 15 years. METHODS 3654 participants aged 49+ years at baseline were followed over 15 years. AMD was assessed from retinal photographs. Deaths and cause of death were confirmed by data linkage with the Australian National Death Index. Hazard ratios (HRs) and 95% confidence intervals (CIs) were assessed using Cox models. RESULTS 71.4% (n=162) and 34.6% (n=1037) of participants with any AMD and no AMD, respectively, died over 15 years. After multivariable-adjustment, no significant associations were observed between AMD and total- and cause-specific mortality in the overall cohort. However, among men, late AMD at baseline was associated with an increased risk of all-cause mortality (n=22; 95.7%), 15 years later: multivariable-adjusted HR, 1.80 (95% CI 1.04-3.11). Women with late AMD had 2-fold increased risk of stroke mortality (n=15; 28.9%), HR 2.10 (95% CI 1.08-4.06). Early-stage AMD was not associated with mortality risk. CONCLUSION Late AMD independently predicted all-cause mortality in men and stroke mortality in women, over 15 years. Although underlying mechanisms are unclear, these findings indicate that late AMD is a marker of biological aging.
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Affiliation(s)
- Bamini Gopinath
- Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia.
| | - Gerald Liew
- Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia
| | - George Burlutsky
- Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia
| | - Paul Mitchell
- Centre for Vision Research, Department of Ophthalmology, Westmead Millennium Institute, The University of Sydney, Sydney, Australia
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Melillo P, Orrico A, Attanasio M, Rossi S, Pecchia L, Chirico F, Testa F, Simonelli F. A pilot study for development of a novel tool for clinical decision making to identify fallers among ophthalmic patients. BMC Med Inform Decis Mak 2015; 15 Suppl 3:S6. [PMID: 26391731 PMCID: PMC4705496 DOI: 10.1186/1472-6947-15-s3-s6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background Falls in the elderly is a major problem. Although falls have a multifactorial etiology, a commonly cited cause of falls in older people is poor vision. This study proposes a method to discriminate fallers and non-fallers among ophthalmic patients, based on data-mining algorithms applied to health and socio-demographic information. Methods A group of 150 subjects aged 55 years and older, recruited at the Eye Clinic of the Second University of Naples, underwent a baseline ophthalmic examination and a standardized questionnaire, including lifestyles, general health, social engagement and eyesight problems. A subject who reported at least one fall within one year was considered as faller, otherwise as non-faller. Different tree-based data-mining algorithms (i.e., C4.5, Adaboost and Random Forest) were used to develop automatic classifiers and their performances were evaluated by assessing the receiver-operator characteristics curve estimated with the 10-fold-crossvalidation approach. Results The best predictive model, based on Random Forest, enabled to identify fallers with a sensitivity and specificity rate of 72.6% and 77.9%, respectively. The most informative variables were: intraocular pressure, best corrected visual acuity and the answers to the total difficulty score of the Activities of Daily Vision Scale (a questionnaire for the measurement of visual disability). Conclusions The current study confirmed that some ophthalmic features (i.e. cataract surgery, lower intraocular pressure values) could be associated with a lower fall risk among visually impaired subjects. Finally, automatic analysis of a combination of visual function parameters (either self-evaluated either by ophthalmological tests) and other health information, by data-mining algorithms, could be a feasible tool for identifying fallers among ophthalmic patients.
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Yuki K, Asaoka R, Tsubota K. Investigating the Influence of Visual Function and Systemic Risk Factors on Falls and Injurious Falls in Glaucoma Using the Structural Equation Modeling. PLoS One 2015; 10:e0129316. [PMID: 26053502 PMCID: PMC4459810 DOI: 10.1371/journal.pone.0129316] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 05/06/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose To investigate the relationship between visual function and the risks of falling and injurious falls in subjects with primary open angle glaucoma (POAG) Methods Questionnaires were conducted in 365 POAG patients to assess history of falls and falls with injury and general patient health. Structural equation modeling (SEM) was used to investigate the relationship between visual function, as measured by a patient’s binocular integrated visual field and visual acuity (VA), general health and the risks of falling and injurious falls. Results Among the 365 subjects, 55 subjects experienced falls in the past year. A significant difference was observed in worse-eye VA between the faller and non-faller groups (p = 0.03). SEM of fallers obtained a Root Mean Square Error of Approximation (RMSEA) of 0.035 and a Comparative Fit Index (CFI) of 0.99. The 95% confidence intervals (CI) of regression coefficients from this model suggested better VA and worse VA were significant risk factors for falling. Among the 55 fallers, 22 subjects experienced an associated injury. There was a significant difference in gender between the non-injurious and injurious faller groups (p = 0.002). SEM of injurious fallers obtained a RMSEA of 0.074 and a CFI of 0.97. In this SEM model, the 95% CI of regression coefficients suggested gender and average total deviation values in the lower peripheral visual field were significant risk factors for an injurious fall. Conclusions This study suggests that worse-eye and better-eye VAs are associated with falls. Furthermore, patients with inferior visual field loss and females were found to be at greater risk of injurious falls.
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Affiliation(s)
- Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, the University of Tokyo, Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan
- * E-mail:
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Shinanomachi 35, Shinjuku-ku, Tokyo, Japan
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Pedula KL, Coleman AL, Yu F, Cauley JA, Ensrud KE, Hochberg MC, Fink HA, Hillier TA. Age-related macular degeneration and mortality in older women: the study of osteoporotic fractures. J Am Geriatr Soc 2015; 63:910-7. [PMID: 25941039 DOI: 10.1111/jgs.13405] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the association between age-related macular degeneration (AMD) and all-cause and cause-specific mortality in a population of older women. DESIGN Prospective cohort study. SETTING Four U.S. clinical centers. PARTICIPANTS A random sample of 1,202 women with graded fundus photographs at the Year 10 visit of the Study of Osteoporotic Fractures (mean age 79.5). MEASUREMENTS Forty-five-degree stereoscopic fundus photographs were graded for presence and severity (early vs late) of AMD. Vital status was adjudicated from death certificates. Cox proportional hazards models, adjusted for appropriate confounders, were used to estimate mortality hazards ratios. RESULTS Prevalence of any AMD was 40.5% at baseline, with 441 (36.7%) having early AMD and 46 (3.8%) having late AMD. Cumulative mortality was 51.6% over 15 years of follow-up. Overall, there was no significant association between AMD presence or severity and all-cause or cause-specific mortality. Because there was a significant interaction between AMD and age in predicting mortality (P<.05 for each mortality type), analyses were stratified according to age group. In women younger than 80, after adjusting for covariates, late AMD was associated with cardiovascular disease (CVD) mortality (hazard ratio (HR)=2.61, 95% confidence interval (CI)=1.05-6.46). In women aged 80 and older, early AMD was associated with all-cause (HR=1.39, 95% CI=1.11-1.75) and non-CVD, noncancer (HR=1.45, 95% CI=1.05-2.00) mortality. Any AMD was associated with all-cause (HR=1.42, 95% CI=1.13-1.78) and CVD (HR=1.45, 95% CI=1.01-2.09) mortality in women aged 80 and older. CONCLUSION AMD is a predictor of poorer survival in women, especially those aged 80 and older. Determination of shared risk factors may identify novel pathways for intervention that may reduce the risk of both conditions.
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Affiliation(s)
- Kathryn L Pedula
- Kaiser Permanente Center for Health Research, Northwest/Hawaii, Portland, Oregon
| | - Anne L Coleman
- Department of Ophthalmology, Jules Stein Eye Institute, David Geffen School of Medicine, Los Angeles, California.,Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Fei Yu
- Department of Epidemiology, School of Public Health, University of California at Los Angeles, Los Angeles, California.,Department of Biostatistics, School of Public Health, University of California at Los Angeles, Los Angeles, California
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kristine E Ensrud
- Veterans Affairs Medical Center, Minneapolis, Minnesota.,Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota
| | - Marc C Hochberg
- Division of Rheumatology, University of Maryland, Baltimore, Maryland
| | - Howard A Fink
- Veterans Affairs Medical Center, Minneapolis, Minnesota.,Department of Medicine, University of Minnesota, Minneapolis, Minnesota.,Department of Epidemiology, University of Minnesota, Minneapolis, Minnesota.,Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Minneapolis, Minnesota
| | - Teresa A Hillier
- Kaiser Permanente Center for Health Research, Northwest/Hawaii, Portland, Oregon
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Loriaut P, Loriaut P, Boyer P, Massin P, Cochereau I. Visual Impairment and Hip Fractures: A Case-Control Study in Elderly Patients. Ophthalmic Res 2014; 52:212-6. [DOI: 10.1159/000362881] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 04/11/2014] [Indexed: 11/19/2022]
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Arora KS, Chang DS, Supakontanasan W, Lakkur M, Friedman DS. Assessment of a rapid method to determine approximate visual acuity in large surveys and other such settings. Am J Ophthalmol 2014; 157:1315-1321.e1. [PMID: 24548874 DOI: 10.1016/j.ajo.2014.02.031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2013] [Revised: 02/12/2014] [Accepted: 02/13/2014] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the efficacy of an iPod application developed to rapidly measure approximate visual acuity (VA). DESIGN Prospective, cross-sectional study. METHODS One hundred four subjects (104 eyes) with a wide range of VA underwent both Early Treatment Diabetic Retinopathy Study (ETDRS) VA testing and iPod application testing. The application presented 4 randomized ETDRS letters at the Snellen equivalent of 20/40 and 20/200 each. In separate analyses, sensitivity and specificity of the iPod test were determined using the ETDRS VA testing results as the gold standard and defining "failure" to see as identifying 1, 2, 3, or all 4 letters incorrectly out of 4 trials. The minimum number of iPod trials necessary to maintain high accuracy was determined by defining a "failure" as getting the first, first 2, first 3, or all trial letters incorrect. In 13 subjects, the time necessary to perform the testing was determined. RESULTS Forty-six subjects had an ETDRS Snellen equivalent VA ≥20/40; 45 had a VA <20/40 and ≥20/200; and 13 had a VA <20/200. The mean ± SD testing time for the 3 groups was 43 ± 13, 60 ± 15, and 72 ± 25 seconds, respectively. The highest sensitivity and specificity combination was observed when a "failure" was defined as getting all letters incorrect for both the 20/40 (sensitivity = 98.3%/specificity = 93.5%) and 20/200 (sensitivity/specificity both 92.3%) cutoffs. CONCLUSIONS An iPod application requiring about a 1-minute testing time provides an objective, portable, rapid, and low-cost method to determine approximate VA, allowing VA testing to be performed efficiently in large surveys and other settings where approximate VA should be measured.
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Affiliation(s)
- Karun S Arora
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland and Dok LLC.
| | - Dolly S Chang
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland and Dok LLC
| | - Wasu Supakontanasan
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland and Dok LLC
| | - Manu Lakkur
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland and Dok LLC
| | - David S Friedman
- Glaucoma Center of Excellence, Wilmer Eye Institute, Johns Hopkins Hospital, Baltimore, Maryland and Dok LLC
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Killebrew SS, Petrella JK, Jung AP, Hensarling RW. The Effect of Loss of Visual Input on Muscle Power in Resistance Trained and Untrained Young Men and Women. J Strength Cond Res 2013; 27:495-500. [DOI: 10.1519/jsc.0b013e3182577091] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Building a basis for action: enhancing public health surveillance of vision impairment and eye health in the United States. Am J Ophthalmol 2012; 154:S8-22.e1. [PMID: 22959360 DOI: 10.1016/j.ajo.2012.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Revised: 06/07/2012] [Accepted: 06/09/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE To examine the ability of current surveillance systems to assess and monitor disparities in: (1) vision impairment, (2) eye disease, (3) vision-related functioning, (4) access to vision and eye care, and (5) access to supports and services for those needing vision rehabilitation. DESIGN Review of surveillance systems and instruments. METHODS We defined surveys and surveillance systems as data collection systems that used an active survey or data abstraction instrument, regardless of the sampling unit, and excluded strictly administrative data sources. We assessed 8 surveys against key surveillance attributes of representativeness, flexibility, and timeliness, as well as their contribution to establishing a national vision surveillance system. RESULTS The key challenges facing a national vision surveillance system are: (1) the lack of consistent outcome data with adequate sample size and coverage to enable identification and tracking of vision health disparities, (2) lack of standardized data elements, and (3) a paucity of data that influence disability such as behavioral and environmental data. CONCLUSIONS Current systems for assessing and monitoring vision health in the United States are limited and do not provide adequate information to guide interventions and policy decisions. Vision surveillance can help to document the burden of the condition, to identify high-risk populations, to develop strategies to reduce the individual and societal burden, and to guide public health programs and policies. Existing surveillance systems could be enhanced by integrating data and by periodically including patient-reported outcomes measurements including, but not limited to, specific barriers for people with vision impairment and related disabilities.
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Källstrand-Eriksson J, Baigi A, Buer N, Hildingh C. Perceived vision-related quality of life and risk of falling among community living elderly people. Scand J Caring Sci 2012; 27:433-9. [DOI: 10.1111/j.1471-6712.2012.01053.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Falls, injuries from falls, health related quality of life and mortality in older adults with vision and hearing impairment—Is there a gender difference? Maturitas 2011; 69:359-64. [DOI: 10.1016/j.maturitas.2011.05.006] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 05/10/2011] [Indexed: 11/18/2022]
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Mänty M, Heinonen A, Viljanen A, Pajala S, Koskenvuo M, Kaprio J, Rantanen T. Self-reported preclinical mobility limitation and fall history as predictors of future falls in older women: prospective cohort study. Osteoporos Int 2010; 21:689-93. [PMID: 19415371 DOI: 10.1007/s00198-009-0950-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2009] [Accepted: 04/20/2009] [Indexed: 10/20/2022]
Abstract
UNLABELLED We studied if self-reported preclinical mobility limitation, described as modification of task performance without perception of difficulty, predicts future falls in older women with and without fall history. Our results suggest that combined measure of self-reported preclinical mobility limitation and fall history may offer one possibility for inexpensive fall-risk evaluation in clinical practice. INTRODUCTION We studied if self-reported preclinical mobility limitation predicts future falls in older women with and without fall history. METHODS The study population consisted of 428 community-living 63-76-year-old women. At baseline, those who expressed no difficulty walking 2 km but reported that it took longer than before or that they did it less often were categorized as having preclinical mobility limitation. Those reporting difficulty in 2-km walk were categorized as having manifest mobility limitation. Fall history was recalled for previous 12 months and dichotomized. The incidence of future falls over 12 months was followed up with fall calendars. RESULTS During the fall follow-up, a total of 440 falls were reported by 201 participants. Among those with fall history, women with preclinical mobility limitation had almost 4-fold (incidence rate ratios 3.77; 95% CI 1.02-13.92) and those with manifest mobility limitation almost 15-fold (14.66; 2.72-79.00) adjusted risk for future falls compared to those with no mobility limitation and no previous falls. Among women without fall history, preclinical and manifest mobility limitation did not predict future falls nor did fall history without mobility limitation. CONCLUSIONS Already, early signs of mobility decline with history of falls increase the risk of further falls and should be considered as indications for fall prevention interventions.
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Affiliation(s)
- M Mänty
- The Finnish Centre for Interdisciplinary Gerontology, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
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Roig M, Eng JJ, Road JD, Reid WD. Falls in patients with chronic obstructive pulmonary disease: a call for further research. Respir Med 2009; 103:1257-69. [PMID: 19419852 DOI: 10.1016/j.rmed.2009.03.022] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2009] [Accepted: 03/31/2009] [Indexed: 12/25/2022]
Abstract
Chronic obstructive pulmonary disease (COPD) is a respiratory disease that results in airflow limitation and respiratory distress. The effects of COPD, however, are not exclusively limited to respiratory function and people with COPD face many non-respiratory manifestations that affect both function and mobility. Deficits in function and mobility have been associated with an increased risk for falling in older adults. The purpose of this study was to provide a theoretical framework to identify risks factors for falls in people with COPD. We have analyzed the literature to identify possible relationships between pathophysiological changes observed in COPD and common risk factors for falls. Well-established fall risk factors in people with COPD include lower limb muscle weakness and impaired activities of daily living. Other intrinsic risk factors such as gait and balance deficits, nutritional depletion, malnutrition, depression, cognitive impairments and medications are possible risk factors that need to be confirmed with more studies. There is no evidence that visual deficits are common in COPD. The role that precipitating factors such as syncope and postural hypotension may have on fall risk is unclear. Exacerbations and dyspnea do not have a precipitating effect on fall risk but they contribute to the progressive physical deterioration that may theoretically increase the risk for falls. While these results suggest that people with COPD might have an increased susceptibility to fall compared to their healthy peers, further research is needed to determine the prevalence of falls and specific risk factors for falls in people living with COPD.
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Affiliation(s)
- Marc Roig
- Department of Physical Therapy, University of British Columbia, 828 West 10th Avenue, Vancouver, Canada.
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Kulmala J, Viljanen A, Sipilä S, Pajala S, Pärssinen O, Kauppinen M, Koskenvuo M, Kaprio J, Rantanen T. Poor vision accompanied with other sensory impairments as a predictor of falls in older women. Age Ageing 2009; 38:162-7. [PMID: 19008307 DOI: 10.1093/ageing/afn228] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES we studied visual acuity (VA) and co-existing hearing impairment and poor standing balance as predictors of falls. DESIGN prospective study with 1-year follow-up. SETTING research laboratory and residential environment. PARTICIPANTS 428 women aged 63-76 years from the Finnish Twin Study on Aging. MEASUREMENTS participants were followed up for incidence of falls over 1 year. VA, hearing ability and standing balance were assessed at the baseline. The incidence rate ratios (IRR) for falls were computed using the negative binomial regression model. RESULTS during the follow-up, 47% of participants experienced a fall. After adjusting for age and interdependence of twin sisters, participants with vision impairment (VA of <1.0) but no other sensory impairments had a higher, but non-significant, risk for falls compared to persons with normal vision (IRR 1.5, 95% CI 0.6-4.2). Co-existing vision impairment and impaired balance increased the risk (IRR 2.7, 95% CI 0.9-8.0), as also did co-existing vision and hearing impairment (IRR 4.2, 95% CI 1.5-11.3), compared to those with normal vision. Among persons with all three impairments, the IRR for falls increased to 29.4 (95% CI 5.8-148.3) compared to participants with good vision. CONCLUSION the impact of vision impairment on fall risk was higher when accompanied with other sensory and balance impairments, probably because the presence of other impairments prevented the reception of compensatory information about body posture and environment being received from other sensory sources. When aiming to prevent falls and their consequences in older people, it is important to check whether poor vision is accompanied with other impairments.
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Affiliation(s)
- Jenni Kulmala
- Department of Health Sciences, The Finnish Centre for Interdisciplinary Gerontology, University of Jyväskylä, Finland.
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