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APHA Scientific Session and Event Listing

Gergana Kodjebacheva, MA¹, Anne L. Coleman, MD, PhD², Fei Yu, PhD², Peter Gutierrez, PhD³, Katie Stone, PhD⁴, Steve Cummings, MD⁴, Jane A. Cauley, DrPH⁵, Kristine E. Ensrud, MD⁶, Teresa Hillier, MD⁷, Marc C. Hochberg, MD, MPH⁸, and Carol M. Mangione, MD, MSPH³. (1) Department of Ophthalmology, Community Health Sciences, UCLA Jules Stein Eye Institute, School of Public Health, 100 Stein Plaza, Los Angeles, CA 90095-7004, 626 794 4544, smolian1@yahoo.com, (2) Department of Ophthalmology, UCLA Jules Stein Eye Institute, 100 Stein Plaza, Los Angeles, CA 90095-7004, (3) Department of Medicine, UCLA David Geffen School of Medicine, 911 Broxton Plaza, Los Angeles, CA 90095, (4) Department of Epidemiology and Biostatistics, University of California, San Francisco, 185 Berry St, San Francisco, CA 94107-1762, (5) Department of Epidemiology, University of Pittsburg, A524 Crabtree Hall, Pittsburgh, PA 15261, (6) Department of Medicine, University of Minnesota, 420 Delaware St. S.E., Minneapolis, MN 55455, (7) Kaiser Permanente Northwest/Hawaii, 3800 N. Interstate Ave, Portland, OR 97227, (8) Departments of Medicine and Epidemiology and Preventive Medicine, University of Maryland, Suite 109 Howard Hall, 660 W. Redwood Street, Baltimore, MD 21201

Since falls are among the leading causes of injury death in elderly individuals, clinicians are advised to evaluate patients' vision when they report recurrent falling (American Geriatrics Society guidelines). However, the recommendations do not specify a method for evaluating vision. Options for vision screening include visual acuity, contrast sensitivity, and binocular visual field loss tests. The association between these aspects of vision, particularly binocular visual field loss and the risk of falling is questionable due to limited and conflicting studies. We tested the association of binocular visual field loss and incident falls in 4,017 white women aged 70 or older, who participated in the multi-center Study of Osteoporotic Fractures (SOF). A total of 643 of 4,071 (16%) women experienced two or more falls within one year after their examination. In logistic regression models adjusted for age, visual acuity, contrast sensitivity and cognitive function, binocular visual field loss was an independent predictor of falls (RR = 1.44, 95% CI: 1.05, 1.96). Additionally, the data showed a trend for increasing odds of two or more falls with greater visual field loss (p<0.0001). In conclusion, binocular visual field loss is an important predictor of subsequent falls in white elderly women. Future research needs to examine the relationship between visual field screening rates and the tendency to falling among the elderly. Primary care providers should consider testing the visual fields of patients when assessing risks of falls.

Learning Objectives: At the conclusion of the talk, participants will be able to

• Identify the negative consequences of falls for elderly individuals.
• Discuss the pros and cons of different vision screening methods, including visual acuity, contrast sensitivity, and binocular visual field loss.

Presenting author's disclosure statement:

Any relevant financial relationships? No