Different aspects of visual impairment as risk factors for falls and fractures in older men and women

Michiel R de Boer, Saskia M F Pluijm, Paul Lips, Annette C Moll, Hennie J Völker-Dieben, Dorly J H Deeg, Ger H M B van Rens

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

UNLABELLED: Visual impairment has been implicated as a risk factor for falling and fractures, but results of previous studies have been inconsistent. The relationship between several aspects of vision and falling/fractures were examined in a prospective cohort study in 1,509 older men and women. The analyses showed that impaired vision is an independent risk factor for both recurrent falling and fractures.

INTRODUCTION: Falls and fractures are a major health problem among the elderly. Visual impairment has been implicated as a risk factor for both falls and fractures. However, results from studies are inconsistent. The inconsistency between findings can primarily be attributed to differences in the designs of these studies. Most studies have been cross-sectional or case-control studies, and many have not correctly adjusted for potential confounders. Furthermore, until now, the potential mediating effects of functional limitation, physical performance, and physical activity have not been examined.

MATERIALS AND METHODS: A total of 1,509 people was examined in 1995-1996. Contrast sensitivity was assessed with the VCTS_6000-1 chart for near vision. In addition, self-reported visual impairment was assessed by questions on recognizing faces from a distance of 4 m, reading the small print in the newspaper, and problems with glare. Furthermore, many potential confounders and mediators were assessed. Falls and fractures were assessed prospectively during a 3-year follow-up period. The associations between the vision variables and falls and fractures were examined using Cox proportional hazards analyses.

RESULTS: After adjustment for potential confounders, contrast sensitivity was shown to be associated with recurrent falling (hazard ratio [HR] = 1.5), and the question on recognizing faces was shown to be associated with fractures (HR = 3.1). Furthermore, functional limitations and physical performance were shown to be mediators in the relationship between vision variables and recurrent falling/fractures.

CONCLUSIONS: The results indicate that impaired vision is an independent risk factor for falling and fractures, but different aspects of visual functioning may have different relationships to falling and fractures.

Original languageEnglish
Pages (from-to)1539-47
Number of pages9
JournalJournal of Bone and Mineral Research
Volume19
Issue number9
DOIs
Publication statusPublished - Sep 2004

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Accidental Falls
Vision Disorders
Contrast Sensitivity
Glare
Newspapers
Case-Control Studies
Reading
Cohort Studies
Prospective Studies
Exercise
Health

Keywords

  • Accidental Falls
  • Aged
  • Aged, 80 and over
  • Contrast Sensitivity
  • Female
  • Follow-Up Studies
  • Fractures, Bone
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Risk Factors
  • Vision, Low
  • Journal Article
  • Research Support, Non-U.S. Gov't

Cite this

de Boer, M. R., Pluijm, S. M. F., Lips, P., Moll, A. C., Völker-Dieben, H. J., Deeg, D. J. H., & van Rens, G. H. M. B. (2004). Different aspects of visual impairment as risk factors for falls and fractures in older men and women. Journal of Bone and Mineral Research, 19(9), 1539-47. https://doi.org/10.1359/JBMR.040504
de Boer, Michiel R ; Pluijm, Saskia M F ; Lips, Paul ; Moll, Annette C ; Völker-Dieben, Hennie J ; Deeg, Dorly J H ; van Rens, Ger H M B. / Different aspects of visual impairment as risk factors for falls and fractures in older men and women. In: Journal of Bone and Mineral Research. 2004 ; Vol. 19, No. 9. pp. 1539-47.
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Different aspects of visual impairment as risk factors for falls and fractures in older men and women. / de Boer, Michiel R; Pluijm, Saskia M F; Lips, Paul; Moll, Annette C; Völker-Dieben, Hennie J; Deeg, Dorly J H; van Rens, Ger H M B.

In: Journal of Bone and Mineral Research, Vol. 19, No. 9, 09.2004, p. 1539-47.

Research output: Contribution to JournalArticleAcademicpeer-review

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T1 - Different aspects of visual impairment as risk factors for falls and fractures in older men and women

AU - de Boer, Michiel R

AU - Pluijm, Saskia M F

AU - Lips, Paul

AU - Moll, Annette C

AU - Völker-Dieben, Hennie J

AU - Deeg, Dorly J H

AU - van Rens, Ger H M B

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N2 - UNLABELLED: Visual impairment has been implicated as a risk factor for falling and fractures, but results of previous studies have been inconsistent. The relationship between several aspects of vision and falling/fractures were examined in a prospective cohort study in 1,509 older men and women. The analyses showed that impaired vision is an independent risk factor for both recurrent falling and fractures.INTRODUCTION: Falls and fractures are a major health problem among the elderly. Visual impairment has been implicated as a risk factor for both falls and fractures. However, results from studies are inconsistent. The inconsistency between findings can primarily be attributed to differences in the designs of these studies. Most studies have been cross-sectional or case-control studies, and many have not correctly adjusted for potential confounders. Furthermore, until now, the potential mediating effects of functional limitation, physical performance, and physical activity have not been examined.MATERIALS AND METHODS: A total of 1,509 people was examined in 1995-1996. Contrast sensitivity was assessed with the VCTS_6000-1 chart for near vision. In addition, self-reported visual impairment was assessed by questions on recognizing faces from a distance of 4 m, reading the small print in the newspaper, and problems with glare. Furthermore, many potential confounders and mediators were assessed. Falls and fractures were assessed prospectively during a 3-year follow-up period. The associations between the vision variables and falls and fractures were examined using Cox proportional hazards analyses.RESULTS: After adjustment for potential confounders, contrast sensitivity was shown to be associated with recurrent falling (hazard ratio [HR] = 1.5), and the question on recognizing faces was shown to be associated with fractures (HR = 3.1). Furthermore, functional limitations and physical performance were shown to be mediators in the relationship between vision variables and recurrent falling/fractures.CONCLUSIONS: The results indicate that impaired vision is an independent risk factor for falling and fractures, but different aspects of visual functioning may have different relationships to falling and fractures.

AB - UNLABELLED: Visual impairment has been implicated as a risk factor for falling and fractures, but results of previous studies have been inconsistent. The relationship between several aspects of vision and falling/fractures were examined in a prospective cohort study in 1,509 older men and women. The analyses showed that impaired vision is an independent risk factor for both recurrent falling and fractures.INTRODUCTION: Falls and fractures are a major health problem among the elderly. Visual impairment has been implicated as a risk factor for both falls and fractures. However, results from studies are inconsistent. The inconsistency between findings can primarily be attributed to differences in the designs of these studies. Most studies have been cross-sectional or case-control studies, and many have not correctly adjusted for potential confounders. Furthermore, until now, the potential mediating effects of functional limitation, physical performance, and physical activity have not been examined.MATERIALS AND METHODS: A total of 1,509 people was examined in 1995-1996. Contrast sensitivity was assessed with the VCTS_6000-1 chart for near vision. In addition, self-reported visual impairment was assessed by questions on recognizing faces from a distance of 4 m, reading the small print in the newspaper, and problems with glare. Furthermore, many potential confounders and mediators were assessed. Falls and fractures were assessed prospectively during a 3-year follow-up period. The associations between the vision variables and falls and fractures were examined using Cox proportional hazards analyses.RESULTS: After adjustment for potential confounders, contrast sensitivity was shown to be associated with recurrent falling (hazard ratio [HR] = 1.5), and the question on recognizing faces was shown to be associated with fractures (HR = 3.1). Furthermore, functional limitations and physical performance were shown to be mediators in the relationship between vision variables and recurrent falling/fractures.CONCLUSIONS: The results indicate that impaired vision is an independent risk factor for falling and fractures, but different aspects of visual functioning may have different relationships to falling and fractures.

KW - Accidental Falls

KW - Aged

KW - Aged, 80 and over

KW - Contrast Sensitivity

KW - Female

KW - Follow-Up Studies

KW - Fractures, Bone

KW - Humans

KW - Longitudinal Studies

KW - Male

KW - Middle Aged

KW - Risk Factors

KW - Vision, Low

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

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DO - 10.1359/JBMR.040504

M3 - Article

VL - 19

SP - 1539

EP - 1547

JO - Journal of Bone and Mineral Research

JF - Journal of Bone and Mineral Research

SN - 0884-0431

IS - 9

ER -