Falls in elderly patients with glaucoma
R. J. Glynn, J. M. Seddon, J. H. Krug Jr, C. R. Sahagian, M. E. Chiavelli and E. W. Campion
Epidemiology Unit, Massachusetts Eye and Ear Infirmary, Boston 02114.
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% Cl, 1.8 to 16.4). Additional risk
factors for falls were female sex (OR, 2.3; 95% Cl, 1.1 to 4.7) and use of
cardiac medications (OR, 2.5; 95% Cl, 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% Cl, 1.0 to 10.1); visual field impairment of
40% or greater (OR, 3.0; 95% Cl, 0.94 to 9.8); and use of sedatives (OR,
2.4; 95% Cl, 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.
