Visual risk factors for falls in older people
Visual risk factors for falls in older people
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DOI：
10.1046/j.1532-5415.2001.49107.x
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发表时间：
2001-05-01
影响因子：
6.3
通讯作者：
Dayhew, J
中科院分区：
文献类型：
--
作者：
Lord, SR;Dayhew, J
目的：从一系列视觉筛查测试（高低对比度视力、边缘对比敏感度、深度知觉和视野大小）中确定最能预测社区居住老年人福尔斯跌倒的测试。为了确定这些视觉测量中的一个或多个是否与感觉、力量、反应时间和平衡测量不相关，可以准确地预测该组的福尔斯。设计：为期12个月的前瞻性队列研究。地点：威尔士亲王医学研究所的福尔斯和平衡实验室。参与者：156名居住在社区的男性和女性，年龄63至90岁（平均年龄76.5岁，标准差= 5.1）。测量：筛选测试：视觉，感觉，力量，反应时间和平衡，福尔斯。结果：在随访的148例受试者中，64例（43.2%）报告跌倒，32例（21.7%）报告多次福尔斯跌倒。多次跌倒者的视力下降，所有的视力测试表明，与受损的深度知觉，对比敏感度，低对比度视力是最强的危险因素。双眼视力良好的受试者的福尔斯率最低，而一只眼睛视力良好而另一只眼睛视力中等或较差的受试者的跌倒率较高-相当于双眼视力中等或较差的受试者。判别分析显示，受损的深度知觉，反应时间慢，增加身体摇摆在一个兼容的表面显着和独立相关的福尔斯。这些变量正确分类的情况下，76%，具有相似的灵敏度和specificity.CONCLUSION：研究结果表明，视力受损是一个重要的和独立的危险因素为福尔斯。足够的深度知觉和远边缘对比敏感度，特别是，似乎是重要的保持平衡和检测和避免环境中的危险。
OBJECTIVES: To determine the tests most predictive of falls in community-dwelling older people from a range of visual screening tests (high and low contrast visual acuity, edge contrast sensitivity, depth perception, and visual field size). To determine whether one or more of these visual measures, ill association with measures of sensation, strength, reaction time, and balance, can accurately predict falls in this group.DESIGN: Prospective cohort study of 12 months duration.SETTING: Falls and Balance Laboratory, Prince of Wales Medical Research Institute.PARTICIPANTS: 156 community-dwelling men and women age 63 to 90 (mean age 76.5, standard deviation = 5.1).MEASUREMENTS: Screening tests of: vision, sensation, strength, reaction time and balance, falls. RESULTS: Of the 148 subjects available at follow-up, 64 (43.2%) reported falling, with 32 (21.7%) reporting multiple falls. Multiple fallers had decreased vision, as indicated by all visual tests, with impaired depth perception, contrast sensitivity, and low-contrast visual acuity being the strongest risk factors. Subjects with good vision in both eyes had the lowest rate of falls, whereas those with good vision in one eye and only moderate or poor vision in the other eye had elevated falling rates-equivalent to those with moderate or poor vision in both eyes. Discriminant analysis revealed that impaired depth perception, slow reaction time, and increased body sway on a compliant surface were significantly and independently associated with falls. These variables correctly classified 76% of the cases, with similar sensitivity and specificity.CONCLUSION: The study findings indicate that impaired vision is an important and independent risk factor for falls. Adequate depth perception and distant-edge-contrast sensitivity, in particular, appear to be important for maintaining balance and detecting and avoiding hazards in the environment.