目标:尽管衰老对视敏度(VA)和跌倒有很大影响,在一般健康的老年人中,他们的相互作用被充分研究。这项研究旨在检查在一般健康的社区居住的老年人中,基线VA是否以及在多大程度上与3年以上的所有和伤害性跌倒的风险增加相关。
方法:DO-HEALTH的观察性分析,双盲,随机对照试验。
方法:7个欧洲中心的多中心试验: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),包括2157名70岁及以上的社区居住成年人,在入学前5年内没有任何重大健康事件,足够的机动性,和良好的认知状态。
方法:通过每3个月的日记和亲自评估,前瞻性记录所有跌倒和伤害性跌倒的次数。基线时VA降低被定义为更好的眼睛VA低于1.0。我们对所有的跌倒和有害的跌倒应用了负二项回归模型,根据年龄调整,性别,之前的瀑布,治疗分配,研究地点,基线体重指数,和使用助行器。
结果:在本分析中包含的2131名参与者中(平均年龄:74.9岁,61.7%是女性,82.6%至少适度的身体活动),1464(68.7%)的VA降低。总的来说,在3年内记录了3290次跌倒,包括2116次伤害性跌倒。基线时VA降低与所有跌倒发生率增加22%相关[校正发生率比(aIRR)=1.22,95%CI1.07,1.38,P=.003]和伤害性跌倒发生率增加20%(aIRR=1.20,95%CI1.05,1.37,P=.007)。
结论:我们的研究结果表明,VA降低是所有和伤害性跌倒风险增加约20%的独立预测因子,强调定期眼科检查和VA测量对预防跌倒的重要性,即使在一般健康和活跃的老年人。
OBJECTIVE: 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.
METHODS: Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial.
METHODS: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: 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.