American Journal of Epidemiology, Vol 152, Issue 7 633-639, Copyright © 2000 by Oxford University Press
RQ Ivers, R Norton, RG Cumming, M Butler and AJ Campbell
As part of a case-control study, the Auckland Hip Fracture Study (1991-
1994), the authors examined associations between impaired vision and risk
of hip fracture. Subjects (911 cases and 910 controls aged 60 years or
older) completed a questionnaire and had vision measurements taken,
including measurements of visual acuity and stereopsis (depth perception).
Binocular visual acuity worse than 20/60 was statistically significantly
associated with increased risk of hip fracture after adjustment for age,
sex, proxy response, hours of activity per week, and height (odds ratio
(OR) = 1.5; 95% confidence interval (CI): 1.1, 2.0), as was having poor
vision (less than 20/100) in both eyes (OR = 2.4; 95% CI: 1.0, 6.1). Having
no depth perception was associated with increased risk (OR = 6.0 95% CI:
3.2, 11.1), as were categories of decreasing stereopsis (trend p = 0.0001),
self-reported poor vision (OR = 1.4; 95% CI: 1.0, 1.9), not wearing glasses
at the time of the fall (OR = 1.2; 95% CI: 1.0, 1.6), and increasing time
since the last eye examination (trend p = 0.03). The population
attributable risk of hip fracture due to poor visual acuity or stereopsis
was 40%. Visual factors are important fall-related factors which influence
risk of hip fracture. Risk of hip fracture may be decreased by correcting
refractive error, improving stereopsis, and administering regular eye
examinations.
ARTICLES
Visual impairment and risk of hip fracture
Department of Public Health and Community Medicine, University of Sydney, Australia. rivers@med.usyd.edu.au
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