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Ramulu PY, Mihailovic A, E JY, et al. Environmental Features Contributing to Falls in Persons With Vision Impairment: The Role of Home Lighting and Home Hazards. Am J Ophthalmol. 2021;230:207-215doi: 10.1016/j.ajo.2021.04.022.
Ramulu, P. Y., Mihailovic, A., E, J. Y., Miller, R. B., West, S. K., Gitlin, L. N., & Friedman, D. S. (2021). Environmental Features Contributing to Falls in Persons With Vision Impairment: The Role of Home Lighting and Home Hazards. American journal of ophthalmology, 230207-215. https://doi.org/10.1016/j.ajo.2021.04.022
Ramulu, Pradeep Y, et al. "Environmental Features Contributing to Falls in Persons With Vision Impairment: The Role of Home Lighting and Home Hazards." American journal of ophthalmology vol. 230 (2021): 207-215. doi: https://doi.org/10.1016/j.ajo.2021.04.022
Ramulu PY, Mihailovic A, E JY, Miller RB, West SK, Gitlin LN, Friedman DS. Environmental Features Contributing to Falls in Persons With Vision Impairment: The Role of Home Lighting and Home Hazards. Am J Ophthalmol. 2021 Oct;230:207-215. doi: 10.1016/j.ajo.2021.04.022. Epub 2021 May 02. PMID: 33951447; PMCID: PMC8560652.
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Am J Ophthalmol. 2021 Oct;230:207-215. doi: 10.1016/j.ajo.2021.04.022. Epub 2021 May 02.

Environmental Features Contributing to Falls in Persons With Vision Impairment: The Role of Home Lighting and Home Hazards.

American journal of ophthalmology

Pradeep Y Ramulu, Aleksandra Mihailovic, Jian-Yu E, Rhonda B Miller, Sheila K West, Laura N Gitlin, David S Friedman

Affiliations

  1. Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD. Electronic address: [email protected].
  2. Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD.
  3. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
  4. Johns Hopkins School of Nursing, Baltimore, MD; College of Nursing and Health Professions, Drexel University, Philadelphia, PA.
  5. Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD; Massachusetts Eye and Ear, Glaucoma Division, Boston, MA, USA.

PMID: 33951447 PMCID: PMC8560652 DOI: 10.1016/j.ajo.2021.04.022

Abstract

PURPOSE: To evaluate whether home hazards and lighting levels are associated with higher fall rates in adults with varying degrees of visual field (VF) damage from glaucoma.

METHODS: Participants with diagnosed or suspected glaucoma provided three years of prospective falls data via monthly falls diaries. A post-fall telephone questionnaire determined fall locations. Seven home areas were evaluated for hazards and lighting via an in-home assessment. Multivariate models adjusting for relevant confounders, including age, sex, comorbidity, and severity of VF damage, evaluated the influence of hazards and lighting on fall rates in each home region.

RESULTS: Mean baseline age for the 170 participants was 71.0 (7.6) years and 78 (46%) of participants were female. Fifty-nine participants experienced a total of 83 home falls, with the greatest number of falls occurring on the indoor stairs (n = 24, 29%) and bedroom (n = 17, 21%). Neither the number nor the percentage of hazardous items graded as hazardous was associated with the rate of falls (P > .26). Each 10-fold increase in room lighting was associated with 35% fewer falls in that home region (P = .02). The relation between lighting and the rate of falls did not differ with the degree of visual field damage (P > .3), and a lower fall rate was noted with better lighting even in participants with mild or no VF damage (rate ratio = 0.52/10-fold better lighting; P = 0.01).

CONCLUSIONS: Fewer home falls were found with better lighting, but not with fewer home hazards. Lighting improvements at home may reduce fall rates in older adults. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Copyright © 2021. Published by Elsevier Inc.

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