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History of falling and visual ability among independently living elderly in Sweden
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). (Hälsa och omvårdnad)ORCID iD: 0000-0002-2333-4316
Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). (Hälsa och omvårdnad)
Lund University, Malmö, Sweden.
2016 (English)In: Clinical Ophthalmology, ISSN 1177-5467, E-ISSN 1177-5483, Vol. 10, 1265-1273 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to assess the performance-based visual ability among independently living elderly subjects and to investigate whether there was any association between visual ability and falls.

Subjects and methods: A total of 298 randomly selected subjects aged 70–85 years were invited for an examination including monocular and binocular visual acuity (VA), contrast sensitivity (CS), stereoscopic vision, and monocular visual fields (VFs), which were integrated to estimate the binocular VFs. Type of lenses used in their habitual correction was noted.

Results: Out of the 212 subjects who were examined, 38% reported at least one fall and 48% of these reported at least two falls during the last 2 years. Most subjects had normal results; 90% had normal binocular VA, 85% had normal binocular CS, and ~80% had positive stereopsis. Twenty-nine subjects had VF defects in the lower quadrants of the binocular VF, and 14 of these reported at least one fall. A significant association was seen between one fall or more and VA better eye, the odds ratio (OR) was 2.26, P=0.013, and between recurrent falls and lack of stereoscopic vision, the OR was 3.23, P=0.002; no other functional test showed any significant association with recurrent falls. The ORs were 1.58 for worse binocular VA, 0.60 for worse binocular CS, and 0.71 for non-normal stereoscopic vision for at least one fall, but wide confidence intervals made it difficult to draw firm conclusions about any association. Bifocal or progressive spectacles were worn by 71% with no significant difference between fallers and nonfallers (P=0.078).

Conclusion: Even though ~40% of the total sample had experienced one or more falls, the only visual function test significantly associated with falls were VA better eye, lack of stereoscopic vision, and recurrent falls. Our results suggest that there may be more powerful predictors of falling than decreased visual ability. © 2016 Källstrand-Eriksson et al.

Place, publisher, year, edition, pages
Auckland: Dove Medical Press , 2016. Vol. 10, 1265-1273 p.
Keyword [en]
elderly, falls, independently living, visual ability
National Category
Ophthalmology
Identifiers
URN: urn:nbn:se:hh:diva-32542DOI: 10.2147/OPTH.S101060ISI: 000379678800001PubMedID: 27468223ScopusID: 2-s2.0-84982696409OAI: oai:DiVA.org:hh-32542DiVA: diva2:1050942
Available from: 2016-11-30 Created: 2016-11-30 Last updated: 2016-12-19Bibliographically approved
In thesis
1. Being on the trail of ageing: Functional visual ability and risk of falling in an increasingly ageing population
Open this publication in new window or tab >>Being on the trail of ageing: Functional visual ability and risk of falling in an increasingly ageing population
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The elderly population is estimated to increase worldwide. One of the major health determinants identified in this population are injuries where one of the most prevalent causes are falls. The overall aim of this thesis was to describe and explore visual impairment and falls of inpatients and independently living elderly in the community and how daily life activities were influenced by visual ability and risk of falling. Methods in the studies were a quantitative retrospective descriptive design for study I followed by two quantitative retrospective and explorative studies where in study II perceived vision related quality of life and in study III performance-based visual ability were investigated. Study IV was a qualitative explorative study using classic grounded theory. In study I all falls of inpatients at a medical clinic 65 years and older (n=68) were registered during one year. In study II and III a random sample (n=212) of independently living elderly between 70 and 85 years of age participated in both studies. In study IV seven women and six men between 73 and 85 years of age from the two previous studies and six visual instructors (n=19) participated. The data in study I was collected during 2004, study II and III between February 2009 to March 2010 and study IV December 2009 to January 2013. The results in study I showed that most falls in five hospital wards occurred at night and those most affected had an established visual impairment. Almost half the population in study II and III fell at least once. Perceived vision when performing daily life activities showed a positive association between visual impairment and falls in men but not in women (II). No associations were found between performance-based measured visual ability and falls (III). Visually impaired elderly did not consider risk of falling as a problem (IV). Their main concern is to remain themselves as who they used to be which is managed by self- preservation while maintaining their residual selves and resisting self decay. Maintaining residual self is done by living in the past mostly driven by inertia while resisting self decay is a proactive and purposeful driven strategy.

It is a complex issue to do fall risk assessments and planning fall preventive action where the individual’s entire life situation has to be taken into consideration.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2014. 85 p.
Series
Örebro Studies in Care Sciences, ISSN 1652-1153 ; 56
Keyword
elderly, experience, falls, independently living, perceived vision, performance-based vision, visual impairment
National Category
Nursing
Identifiers
urn:nbn:se:hh:diva-32749 (URN)978-91-7529-018-8 (ISBN)
Public defence
2014-05-30, Haldasalen, Högskolan Halmstad, Halmstad, 11:25 (English)
Opponent
Supervisors
Note

Medicine doktorsexamen

Available from: 2017-01-10 Created: 2016-12-19 Last updated: 2017-01-10Bibliographically approved

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