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  • Assessing Fear of Falling in Patients With POAG

    By Lynda Seminara
    Selected By: Prem S. Subramanian, MD, PhD
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    Journal Highlights

    Investigative Ophthalmology & Visual Science
    2020;61(3):52

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    Previous research has correlated visual field loss with reduced activity levels in patients with primary open-angle glaucoma (POAG), and there is a need to explore the role of falls and fear of falls in patient behaviors. Yuki et al. set out to determine which factors drive the fear of falling among patients with POAG and to explore the relationship between this fear and visual field (VF) loss. They found that fear of falling was more pronounced for older adults, women, and those patients who have damage to the inferior peripheral VF.

    For this cross-sectional observa­tional study, the authors evaluated 273 patients with POAG (average age, 64.2 years), using the Fall Efficacy Scale–International (FES-I) questionnaire during face-to-face interviews. Multi­variable linear regression was used to explore relationships between the total FES-I score and age, sex, and level of best-corrected visual acuity as well as other factors, such as time spent walk-ing each day, total deviation (TD) in four VF areas, and number of previous falls.

    Results showed that fear of falling increased with age and was higher for women. Reduced inferior peripheral VF sensitivity and increased inferior central VF sensitivity correlated with greater fear of falling. No meaningful associations were observed for other variables, including the number of previous falls. Only four of the 13 study variables were included in the opti­mal model for total FES-I score: age (coefficient, 0.23; standard error [SE], 0.04; p < .001), sex (coefficient, 1.79 for women; SE, 0.84; p = .034), and mean TD in the inferior central area (coeffi­cient, 0.92; SE, 0.22; p < .001) and the inferior peripheral area (coefficient, –0.86; SE, 0.21; p < 0.001).

    The authors believe that this study is the first to use the FES-I questionnaire to assess fear of falling in patients with glaucoma. In addition to being aware of the demographic factors linked to greater fear, they said, additional at­tention should be paid to patients with damage in the inferior peripheral VF.

    The original article can be found here.