Impaired Vision and Hip Fracture
Impaired Vision and Hip Fracture
复制标题
视力受损和髋部骨折
DOI：
--
复制
发表时间：
1989
影响因子：
6.3
通讯作者：
D. Kiel
中科院分区：
文献类型：
--
作者：
D. Felson;Jennifer J. Anderson;M. Hannan;R. Milton;P. Wilson;D. Kiel
福尔斯影响了很大一部分老年人，并可能导致各种伤害，包括髋部骨折。几项研究表明，视力损害有助于福尔斯，但研究没有使用标准化的定义视力损害，并没有检查伤害性福尔斯或骨折。我们观察了1973-75年参加过Frachial Eye研究的Frachial研究队列成员中与视力障碍相关的髋部骨折风险。在2,633名受试者中，有110人在眼科检查后持续骨折。视力中度受损（20/30至20/80）（8.5%）和视力差（20/100或更差）（11.3%）的骨折率高于视力良好（20/25或更好）的患者（3.0%）。在调整年龄、性别、体重、饮酒和雌激素使用（女性）后，中度损伤者骨折的相对危险度为1.54（95%CI = 0.95-2.49），而视力差者骨折的相对危险度为2.17（95%CI = 1.24-3.80）。值得注意的是，那些一只眼睛视力中度受损而另一只眼睛视力良好的人骨折的风险（相对风险= 1.94）高于双眼受损程度相似的人（相对风险= 2.11）。单眼或双眼视力差与骨折风险增加有关。这表明，良好的立体视觉可能是必要的，以防止福尔斯。在女性中，伴有视力差和中度受损的骨折风险增加（相对风险= 1.96，95%CI = 1.23-3.11），但在男性中没有增加（相对风险= 0.79，95%CI = 0.23-2.72）。17.5%（17/97）至少一只眼睛视力不佳的女性在研究的10年期间持续髋骨骨折。白内障是骨折相关视力损害的最常见原因，但在调整视力后，白内障或其他常见眼病对骨折风险均无独立影响。总之，视力障碍是髋部骨折的一个重要危险因素，尤其是在老年妇女中。
Falls affect a large proportion of the elderly and can result in a variety of injuries, including hip fractures. Several studies have suggested that visual impairment contributes to falls, but studies have not used standardized definitions of visual impairment and have not examined injurious falls or fractures. We looked at the risk of hip fracture associated with visual impairment in those members of the Framingham Study Cohort who took part in the Framingham Eye Study in 1973–75. Of 2,633 subjects followed for 10 years after the eye exam, 110 sustained hip fractures. The fracture rates in those with moderately impaired (20/30 to 20/80) vision (8.5%) and poor (20/100 or worse) vision (11.3%) were higher than in those with good (20/25 or better) vision (3.0%). After adjustment for age, sex, weight, alcohol consumption, and (in women) estrogen use, the relative risk of fracture in those with moderate impairment was 1.54 (95% CI = 0.95–2.49), while for those with poor vision, the relative risk was 2.17 (95% CI = 1.24–3.80). Of note, those with moderately impaired vision in one eye and good vision in the other had a higher risk of fracture (relative risk = 1.94) than those with a similar degree of binocular impairment (relative risk = 2.11). Poor vision in one or both eyes was linked to an elevated fracture risk. This suggests that good stereoscopic vision may be necessary to prevent falls. The risk of fracture with poor and moderately impaired vision combined was increased in women (relative risk = 1.96, 95% CI = 1.23–3.11) but not in men (relative risk = 0.79, 95% CI = 0.23–2.72). 17.5% (17/97) of women with poor vision in at least one eye sustained a hip fracture during the 10 years of the study. Cataracts were the most common cause of fracture‐related visual impairment, but neither cataracts nor other common eye diseases had an independent effect on fracture risk after adjustment for visual acuity. In sum, visual impairment is an important risk factor for hip fracture, especially among elderly women.