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February 1991

Falls in Elderly Patients With Glaucoma

Author Affiliations

From the Epidemiology Unit (Drs Glynn and Seddon and Ms Sahagian) and the Glaucoma Consultation Service (Dr Krug and Ms Chiavelli), Department of Ophthalmology, Massachusetts Eye and Ear Infirmary; and the General Internal Medicine Unit and the Division on Aging, Massachusetts General Hospital, Harvard Medical School (Dr Campion), Boston. Dr Glynn is now with Brigham and Women's Hospital, Brookline, Mass.

Arch Ophthalmol. 1991;109(2):205-210. doi:10.1001/archopht.1991.01080020051041

• We analyzed the determinants of serious falls among 489 ambulatory elders aged 65 years and older who received a comprehensive examination at a glaucoma consultation service. For the previous year, at least one fall requiring medical attention or restricted activity was reported by 9.6% (95% confidence interval [CI], 7.0% to 12.2%) of participants. Using logistic regression to adjust for potential confounding variables, the greatest single risk factor for falls was the use of nonmiotic topical eye medications (odds ratio [OR], 5.4; 95% CI, 1.8 to 16.4). Additional risk factors for falls were female sex (OR, 2.3; 95% CI, 1.1 to 4.7) and use of cardiac medications (OR, 2.5; 95% CI, 1.1 to 5.6). Three other characteristics were also associated with the risk of falls: use of miotic eye medications (OR, 3.2; 95% CI, 1.0 to 10.1); visual field impairment of 40% or greater (OR, 3.0; 95% CI, 0.94 to 9.8); and use of sedatives (OR, 2.4; 95% CI, 0.89 to 6.7). These findings suggest that ocular and systemic medications are the major predictors of falls even in this elderly population seeking ophthalmologic care for glaucoma. Medications appear to pose a greater risk for falls than even major visual impairment.

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