Evaluation of away-from-home excursion patterns after falling among individuals with glaucoma: a longitudinal study

Catalina Garzon; Aleksandra Mihailovic; E Jian-Yu; Sheila K West; Laura N Gitlin; David S Friedman; Pradeep Y Ramulu

doi:10.1186/s12877-022-02788-z

Evaluation of away-from-home excursion patterns after falling among individuals with glaucoma: a longitudinal study

BMC Geriatr. 2022 Feb 4;22(1):101. doi: 10.1186/s12877-022-02788-z.

Authors

Catalina Garzon¹, Aleksandra Mihailovic¹, E Jian-Yu¹, Sheila K West¹, Laura N Gitlin², David S Friedman³, Pradeep Y Ramulu⁴

Affiliations

¹ Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Maumenee B110, Baltimore, MD, 21287, USA.
² College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA.
³ Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
⁴ Wilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Maumenee B110, Baltimore, MD, 21287, USA. pramulu@jhmi.edu.

Abstract

Background: Unintentional falls among older adults are associated with an ensuing decline in physical activity. Our objective is to evaluate the associations between fall status and changes in excursions after a fall.

Methods: Prospective cohort study of older adults with glaucoma or suspected glaucoma who reported falls for 1 year and wore a GPS device for 1-week at the baseline and 1 year later. GPS data were quantified into average: daily excursions, daily time away from home, and time per excursion. Fall status was categorized as fallers, injurious fallers, recurrent fallers, and recurrent injurious fallers. Multivariable negative binomial regression and generalized estimating equations models were employed to evaluate relationship between excursion parameters and fall status.

Results: A total of 192 eligible participants were included in the analyses. Approximately half were males (50.5%) with a mean age of 70.1 years and one-fourth were Black (28.1%). There were no significant associations between fall status and end-of-study excursion parameters (p > 0.06 for all), and visual field damage did not modify these relationships (p > 0.07 for all). For instance, patients with multiple falls during a one-year study period did not demonstrate more daily excursions (incident rate ratio [IRR] = 1.16, 95% confidence interval [CI] = 0.85 to 1.57), longer time per excursion (IRR = 0.79, 95% CI =0.59 to 1.06), or more average daily time away (IRR = 1.05, 95% CI = 0.84 to 1.30) conducted at the end-of-the study. Excursion parameters at the final assessment were not significantly different from those at baseline (p > 0.09 for all) and the changes did not vary by fall status (p > 0.23 for all).

Conclusions: Older adults with glaucoma did not modify their travel away from home after experiencing a fall. Additional research is necessary to understand how often maintenance of travel outside the home after a fall reflects proper compensation for greater fall risk or continued activity despite the risk of falling.

Keywords: Fall; Glaucoma; Mobility; Physical activity; Trips; Vision impairment.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls* / prevention & control
Aged
Exercise
Glaucoma* / diagnosis
Glaucoma* / epidemiology
Humans
Longitudinal Studies
Male
Prospective Studies