OBJECTIVES: To determine whether visual field (VF) damage or other factors confer a similar risk of falling when falls are ascertained as a rate over time (falls/year) as when ascertained over activity (falls/step). DESIGN: Prospective, observational cohort study. SETTING: Clinic-based recruitment with real-world monitoring of falls and physical activity. PARTICPANTS: Individuals with glaucoma or suspected glaucoma (N=230). MEASUREMENTS: Participants recorded falls using daily calendars, with injuries identified in a follow-up questionnaire. Annual 1-week accelerometer trials were used to estimate steps. VF results from both eyes were merged to determine integrated VF sensitivity, with lower sensitivity indicating greater VF damage. Other potential risk factors for falls (age, sex, race, comorbid illness, polypharmacy) were determined using questionnaires. RESULTS: The cumulative probability of falls was 45.2% at 12 months and 61.6% at 24 months; cumulative probability of injurious falls was 23.3% at 12 months and 40.0% at 24 months. Greater VF damage was associated with higher rates of falls/steps (incident rate ratio = 1.40/5 dB decrement in sensitivity; p = .004) but not with more falls/year (incident rate ratio = 1.25/5 dB decrement in sensitivity; p = .07). Several additional variables (older age, female sex, more comorbid disease) were also associated with a higher rate of falls/step (p < .02 for all) but not with falls/year (p > 0.10). Black participants had fewer falls/year than whites (p = .002) but did not differ in falls/step (p = .07). Similar results were obtained when injurious falls were analyzed. CONCLUSIONS: Risk factors associated with frequent falls when walking (falls/step) are not properly identified when analyzing falls as a rate over time (falls/year). Given the clinical importance of preventing falls while preserving physical activity, falls assessment integrated with activity measurement is recommended when determining whether a risk factor is associated with falls. J Am Geriatr Soc 67:87-92, 2019.
OBJECTIVES: To determine whether visual field (VF) damage or other factors confer a similar risk of falling when falls are ascertained as a rate over time (falls/year) as when ascertained over activity (falls/step). DESIGN: Prospective, observational cohort study. SETTING: Clinic-based recruitment with real-world monitoring of falls and physical activity. PARTICPANTS: Individuals with glaucoma or suspected glaucoma (N=230). MEASUREMENTS: Participants recorded falls using daily calendars, with injuries identified in a follow-up questionnaire. Annual 1-week accelerometer trials were used to estimate steps. VF results from both eyes were merged to determine integrated VF sensitivity, with lower sensitivity indicating greater VF damage. Other potential risk factors for falls (age, sex, race, comorbid illness, polypharmacy) were determined using questionnaires. RESULTS: The cumulative probability of falls was 45.2% at 12 months and 61.6% at 24 months; cumulative probability of injurious falls was 23.3% at 12 months and 40.0% at 24 months. Greater VF damage was associated with higher rates of falls/steps (incident rate ratio = 1.40/5 dB decrement in sensitivity; p = .004) but not with more falls/year (incident rate ratio = 1.25/5 dB decrement in sensitivity; p = .07). Several additional variables (older age, female sex, more comorbid disease) were also associated with a higher rate of falls/step (p < .02 for all) but not with falls/year (p > 0.10). Black participants had fewer falls/year than whites (p = .002) but did not differ in falls/step (p = .07). Similar results were obtained when injurious falls were analyzed. CONCLUSIONS: Risk factors associated with frequent falls when walking (falls/step) are not properly identified when analyzing falls as a rate over time (falls/year). Given the clinical importance of preventing falls while preserving physical activity, falls assessment integrated with activity measurement is recommended when determining whether a risk factor is associated with falls. J Am Geriatr Soc 67:87-92, 2019.
Authors: Audie A Atienza; Richard P Moser; Frank Perna; Kevin Dodd; Rachel Ballard-Barbash; Richard P Troiano; David Berrigan Journal: Med Sci Sports Exerc Date: 2011-05 Impact factor: 5.411
Authors: Aviroop Biswas; Paul I Oh; Guy E Faulkner; Ravi R Bajaj; Michael A Silver; Marc S Mitchell; David A Alter Journal: Ann Intern Med Date: 2015-01-20 Impact factor: 25.391
Authors: Pradeep Y Ramulu; Eugenio Maul; Chad Hochberg; Emilie S Chan; Luigi Ferrucci; David S Friedman Journal: Ophthalmology Date: 2012-03-02 Impact factor: 12.079
Authors: Danijela Gnjidic; Sarah N Hilmer; Fiona M Blyth; Vasi Naganathan; Louise Waite; Markus J Seibel; Andrew J McLachlan; Robert G Cumming; David J Handelsman; David G Le Couteur Journal: J Clin Epidemiol Date: 2012-06-27 Impact factor: 6.437
Authors: M A Province; E C Hadley; M C Hornbrook; L A Lipsitz; J P Miller; C D Mulrow; M G Ory; R W Sattin; M E Tinetti; S L Wolf Journal: JAMA Date: 1995-05-03 Impact factor: 56.272
Authors: Ecosse L Lamoureux; Ecosse L Lamoreux; Elaine Chong; Jie Jin Wang; Seang Mei Saw; Tin Aung; Paul Mitchell; Tien Yin Wong Journal: Invest Ophthalmol Vis Sci Date: 2008-02 Impact factor: 4.799
Authors: Aleksandra Mihailovic; Bonnielin K Swenor; David S Friedman; Sheila K West; Laura N Gitlin; Pradeep Y Ramulu Journal: Transl Vis Sci Technol Date: 2017-06-23 Impact factor: 3.283
Authors: Pradeep Y Ramulu; Aleksandra Mihailovic; Sheila K West; Laura N Gitlin; David S Friedman Journal: Am J Ophthalmol Date: 2019-01-09 Impact factor: 5.258
Authors: Jian-Yu E; Aleksandra Mihailovic; Jennifer A Schrack; Tianjing Li; David S Friedman; Sheila K West; Laura N Gitlin; Pradeep Y Ramulu Journal: J Am Geriatr Soc Date: 2021-01-08 Impact factor: 5.562
Authors: Vivek Trivedi; Ji Won Bang; Carlos Parra; Max K Colbert; Caitlin O'Connell; Ahmel Arshad; Muneeb A Faiq; Ian P Conner; Mark S Redfern; Gadi Wollstein; Joel S Schuman; Rakie Cham; Kevin C Chan Journal: Sci Rep Date: 2019-10-02 Impact factor: 4.379
Authors: Samuel R Nyman; Wendy Ingram; Jeanette Sanders; Peter W Thomas; Sarah Thomas; Michael Vassallo; James Raftery; Iram Bibi; Yolanda Barrado-Martín Journal: Clin Interv Aging Date: 2019-11-19 Impact factor: 4.458
Authors: Amanda K Bicket; Aleksandra Mihailovic; Jian-Yu E; Angeline Nguyen; Moneesha Rani Mukherjee; David S Friedman; Pradeep Y Ramulu Journal: Transl Vis Sci Technol Date: 2020-12-16 Impact factor: 3.283
Authors: Hursuong Vongsachang; Aleksandra Mihailovic; Jian-Yu E; David S Friedman; Sheila K West; Laura N Gitlin; Pradeep Y Ramulu Journal: Sensors (Basel) Date: 2021-05-14 Impact factor: 3.576
Authors: Anjali M Bhorade; Monica S Perlmutter; Sharon L Sabapathypillai; Manik Goel; Bradley Wilson; Mae O Gordon Journal: Am J Ophthalmol Date: 2021-02-21 Impact factor: 5.488