Older Adults With Certain Eye Diseases at Increased Risk of Falls and Fractures

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A recent study of older adults with cataracts, age-related macular degeneration, and glaucoma found that this population has at least a 25 percent higher risk.

Adults over the age of 65 with glaucoma, cataracts, or age-related macular degeneration (AMD) are at an increased risk of experiencing falls or developing fractures compared to older adults with healthy eyes, a new study reports.

To determine the risks the eye conditions pose, Dr. Jung Yin Tsang of the University of Manchester and his team reviewed data from electronic medical records of adults in England between 2007 and 2020. They compared data from 3.4 million people, including 410,476 with cataracts, 75,622 with AMD, and 90,177 with glaucoma. Patients and controls were followed for an average of about four years. Most participants were white, and over half were women. The average age for each eye disease varied, falling between 69 and 80 years old.

The researchers discovered that patients with cataracts had a 36 percent increased risk of experiencing falls, those with AMD had a 25 percent increased risk, and those with glaucoma had a 38 percent increased risk.

The results were similar when comparing fracture incidents of those with the eye conditions to healthy controls. People with cataracts faced a 28 percent increased risk of fractures, while those with AMD faced an 18 percent increase, and those with glaucoma had a 31 percent increase.

Dr. Tsang’s team noted they could not determine from the medical records whether the eye conditions affected one or both eyes.

“Our findings further build the evidence base demonstrating that all 3 eye diseases are important risk factors for falls and fractures,” the team wrote. The study was published in JAMA Ophthalmology on Dec. 28, 2023.

The Cost of Falls

According to the U.S. Centers for Disease Control and Prevention (CDC), falls among adults 65 and older resulted in the death of over 36,000 individuals in 2020, making it the leading cause of injury death for that group. In the same year, falls sent 3 million adults in that age group to the emergency room. Common injuries include broken bones or hip fractures. Falls can also cause potentially serious head injuries, especially if an individual is taking a blood thinner.

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Falls aren’t just painful or deadly; they’re also costly. Falls accounted for $50 billion in medical care costs in 2015, most of which was paid by Medicare and Medicaid.

How to Prevent Falls

Ophthalmologists and other health care providers can help older patients with glaucoma, AMD, and cataracts by helping them understand the increased risk of falls.

“These populations would likely benefit from improved advice, access, and referrals to falls prevention services and targeted interventions to prevent related adverse outcomes,” Dr. Tsang and his team wrote.

The CDC recommends the following four simple steps to help prevent falls:

  • Step 1: Talk to your health care provider. He or she can evaluate your risk of falling and review any medications you may be taking to determine if they make you sleepy or dizzy.
  • Step 2: Engage in strength and balancing exercises to strengthen your legs and improve balance. Tai chi is an easy but effective exercise.
  • Step 3: Make your home safer. Remove objects you can trip over, and consider adding bars around the tub, shower, toilet, and stairs.
  • Step 4: Connect with an eye doctor at least once a year to assess your eye health.

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