Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial

Foss, Alexander; Harwood, Rowan H.; Osborn, Francis; Gregson, R; Zaman, Anwar; Masud, Tahir

doi:10.1093/ageing/afj005

Cited by 125 publications

(123 citation statements)

References 30 publications

Supporting

Mentioning

108

Contrasting

Unclassified

Order By: Relevance

“…53 The same group showed second eye cataract surgery improved vision and general status. Surgery reduced the rate of falling by 32% compared with controls, but this was not statistically significant (OR 0.68, 95% CI 0.39-1.19, P ¼ 0.18) 54 The number of individuals who fell was again low in this study, and this may be a factor in the lack of statistical significance. However, it is possible that patients' activity level and behaviour may alter after surgery, thus affecting the fall-risk.…”

Section: Cataracts and Fallscontrasting

confidence: 70%

Visual loss and falls: a review

Dhital

Pey

Stanford

2010

Eye

148

116

View full text Add to dashboard Cite

show abstract

Section: Cataracts and Fallscontrasting

confidence: 70%

Visual loss and falls: a review

Dhital

Pey

Stanford

2010

Eye

148

116

View full text Add to dashboard Cite

show abstract

“…Province et al (1995), Gillespie et al (2001), Li et al (2005), Faber et al (2006) suggested that significant improvements in risk of falls can be achieved through exercise programs, although this finding is not universal (Cumming et al, 2007). However, there have been few studies aimed at decreasing the risk of falls by improving visual function (Day et al, 2002;Harwood et al, 2005;Foss et al, 2006). Some of these have been limited by the poor followup for treatment (Day et al, 2002) or dealt only with cataract surgery (Harwood et al, 2005;Foss et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…However, there have been few studies aimed at decreasing the risk of falls by improving visual function (Day et al, 2002;Harwood et al, 2005;Foss et al, 2006). Some of these have been limited by the poor followup for treatment (Day et al, 2002) or dealt only with cataract surgery (Harwood et al, 2005;Foss et al, 2006). The randomized controlled trial by Cumming et al (2007) took a more comprehensive approach to diagnosing and intervening upon vision abnormalities for the prevention of falls in older adults.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers of aging and falling: The Beaver Dam eye study

Knudtson

Klein

2009

Archives of Gerontology and Geriatrics

View full text Add to dashboard Cite

Falls are an important cause of morbidity in older adults and are an important source of health care spending. We hypothesize that falls are associated with systemic biomarkers of aging. The following functions, measured at the 1998-2000 and 2003-05 examinations of the Beaver Dam Eye study, were considered to be biomarkers of aging (frailties): poorer visual acuity, contrast sensitivity or discrepant vision between the eyes, inability to rise from a chair, slower gait time, poorer hand grip strength, and lower peak expiratory flow rate. We found that poorer values on biomarkers of aging (frailties) at the 1998-2000 examination were associated with 2 or more reported falls in the past year at the 2003-05 examination (p < 0.05 for all markers except peak expiratory flow rate). When the markers were combined as an index of biological aging (frailty), the index was significantly associated with falls after controlling for significant confounders (odds ratio per 1 step increase in the index: 1.33; 95% confidence interval = CI = 1.13-1.57) We conclude that biomarkers of aging, including any of three measures of visual function, are associated with falls. Improvement in these functional measures may lead to decreased risk of falls.

show abstract

“…79 A similar study investigated the effects of second eye surgery on falls, finding no significant difference for any of the measures of falls between the groups with expedited second eye cataract surgery and those remaining on the waiting list for second eye surgery. 147 Based on these studies, a Cochrane review included in its implications for practice that 'Expedited first eye cataract surgery for people on a waiting list significantly reduces rate of falls compared with waiting list controls'. 148 Recommendations for clinical practice for the management of those at moderate or high risk of falling, which includes people with dementia, included having regular eye examinations and early referral for first eye cataract extraction as appropriate.…”

Section: Expedited Cataract Surgerymentioning

confidence: 99%

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Bowen

Edgar

Hancock

et al. 2016

Health Serv Deliv Res

121

View full text Add to dashboard Cite

BackgroundThe prevalence of visual impairment (VI) and dementia increases with age and these conditions may coexist, but few UK data exist on VI among people with dementia.ObjectivesTo measure the prevalence of eye conditions causing VI in people with dementia and to identify/describe reasons for underdetection or inappropriate management.DesignStage 1 – cross-sectional prevalence study. Stage 2 – qualitative research exploring participant, carer and professional perspectives of eye care.SettingStage 1 – 20 NHS sites in six English regions. Stage 2 – six English regions.ParticipantsStage 1 – 708 participants with dementia (aged 60–89 years): 389 lived in the community (group 1) and 319 lived in care homes (group 2). Stage 2 – 119 participants.InterventionsStage 1 gathered eye examination data following domiciliary sight tests complying with General Ophthalmic Services requirements and professional guidelines. Cognitive impairment was assessed using the Standardised Mini-Mental State Examination (sMMSE) test, and functional ability and behaviour were assessed using the Bristol Activities of Daily Living Scale and Cambridge Behavioural Inventory – Revised. Stage 2 involved individual interviews (36 people with dementia and 11 care workers); and separate focus groups (34 optometrists; 38 family and professional carers).Main outcome measures.VI defined by visual acuity (VA) worse than 6/12 or worse than 6/18 measured before and after refraction.ResultsStage 1 – when participants wore their current spectacles, VI prevalence was 32.5% [95% confidence interval (CI) 28.7% to 36.5%] and 16.3% (95% CI 13.5% to 19.6%) for commonly used criteria for VI of VA worse than 6/12 and 6/18, respectively. Of those with VI, 44% (VA < 6/12) and 47% (VA < 6/18) were correctable with new spectacles. Almost 50% of remaining uncorrectable VI (VA < 6/12) was associated with cataract, and was, therefore, potentially remediable, and one-third was associated with macular degeneration. Uncorrected/undercorrected VI prevalence (VA < 6/12) was significantly higher in participants in care homes (odds ratio 2.19, 95% CI 1.30 to 3.73;p < 0.01) when adjusted for age, sex and sMMSE score. VA could not be measured in 2.6% of group 1 and 34.2% of group 2 participants (p < 0.01). The main eye examination elements (excluding visual fields) could be performed in > 80% of participants. There was no evidence that the management of VI in people with dementia differed from that in older people in general. Exploratory analysis suggested significant deficits in some vision-related aspects of function and behaviour in participants with VI. Stage 2 key messages – carers and care workers underestimated how much can be achieved in an eye examination. People with dementia and carers were unaware of domiciliary sight test availability. Improved communication is needed between optometrists and carers; optometrists should be informed of the person’s dementia. Tailoring eye examinations to individual needs includes allowing extra time. Optometrists wanted training and guidance about dementia. Correcting VI may improve the quality of life of people with dementia but should be weighed against the risks and burdens of undergoing examinations and cataract surgery on an individual basis.LimitationsSampling bias is possible owing to quota-sampling and response bias.ConclusionsThe prevalence of VI is disproportionately higher in people with dementia living in care homes. Almost 50% of presenting VI is correctable with spectacles, and more with cataract surgery. Areas for future research are the development of an eye-care pathway for people with dementia; assessment of the benefits of early cataract surgery; and research into the feasibility of specialist optometrists for older people.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

show abstract

Falls and health status in elderly women following second eye cataract surgery: a randomised controlled trial

Abstract: second eye cataract surgery improves visual disability and general health status. The effect on rate of falling remains uncertain.

Cited by 125 publications

References 30 publications

Visual loss and falls: a review

Visual loss and falls: a review

Biomarkers of aging and falling: The Beaver Dam eye study

The Prevalence of Visual Impairment in People with Dementia (the PrOVIDe study): a cross-sectional study of people aged 60–89 years with dementia and qualitative exploration of individual, carer and professional perspectives

Contact Info

Product

Resources

About