Factors associated with falls in older adults with cataracts

Paz, Leonardo Petrus da Silva; Borges, Larissa de Lima; Marães, Vera Regina Fernandes da Silva; Gomes, Marília Miranda Forte; Bachion, Maria Márcia; Menezes, Ruth Losada de

doi:10.1590/1413-81232018238.14622016

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ARTICLES • Ciênc. saúde colet. 23 (8) • Aug 2018 • https://doi.org/10.1590/1413-81232018238.14622016 copy

Factors associated with falls in older adults with cataracts

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

The aim of the present study was to evaluate factors associated with falls in community-dwelling older adults diagnosed with cataracts. An analytical, cross-sectional study was conducted with a sample of community-dwelling older adults residing in the Federal District of Brazil. Interviews and assessment tools were administered, such as the Timed Up and Go test, Short Physical Performance Battery (SPPB), Biodex Balance System, Katz Index, Lawton Scale, Minnesota Leisure Time Physical Activity Questionnaire and Mini Mental State Examination. Statistical analysis involved binary logistic regression. One hundred forty-two older adults (85 with cataracts) participated in the study (mean age: 69.39 ± 5.67 years). Falls were associated with the female sex (OR: 4.45) and sub-maximum score on the SPPB (OR: 3.53) among patients with cataracts, whereas multimorbidity (OR: 5.10) was the risk factor risk for older adults without cataracts. The data suggest different risk factors for falls among older adults diagnosed with cataracts.

Accidental falls; Cataract; Aged; Postural balance; Physical fitness

Variable	With cataract (n = 85)			Without cataract (n = 57)

	n	%	Mean (± SD)	n	%	Mean (± SD)	p
Falls
No	52	61.18%		24	42.11%		0.70
Yes	33	38.82%		33	57.80%
Age
< 75 years	67	78.82%		51	89.47%		0.97
> 75 years	18	21.18%		6	10.53%
Sex
Male	31	36.47%		20	35.09%		0.86
Female	54	63.53%		37	64.91%
Marital status
Married or lives with partner	47	55.29%		29	50.88%		0.93
Single	8	9.41%		6	10.53%
Divorced or separated	8	9.41%		7	12.28%
Widowed	22	25.88%		15	26.32%
Absence of spouse
No	47	55.29%		29	50.88%		0.60
Yes	38	44.71%		28	49.12%
Reading and writing skills
No	23	27.06%		10	17.54%
Yes	62	72.94%		47	82.46%		0.19
Multimorbidity
No	66	77.65%		43	75.44%
Yes	19	22.35%		14	24.56%		0.378
Use of psychotropic agent
No	66	88.00%		38	88.37%		0.95
Yes	9	12.00%		5	11.63%
Polypharmacy (3 or more)
No	31	36%		40	47%		0.28
Yes	24	28%		45	53%
Deficient visual acuity
No	53	62.40%		50	87.70%		0.01
Yes	32	37.60%		7	12.30%
Katz index			0.47 (± 0.52)			0.32 (± 0.46)	0.19
Lawton scale			24.20 (± 3.29			25.26 (± 2.83)	0.60
Mini Mental State Examination			24.33 (± 3.36)			24.84 (± 3.28)	0.5
Frailty status
Non-frail	32	37.65%		14	24.56%		0.26
Pre-frail	52	61.18%		42	73.68%
Frail	1	1.18%		1	1.75%
Level of physical activity
Active	45	52.90%		31	54.40%		0.20
Non-active	40	47.10%		26	45.60%
Risk of falls (BBS)
Low risk	62	72.94%		44	77.20%		0.57
High risk	23	27.06%		13	22.80%
TUG – cutoff: 7.67 seconds
Low risk (< 7.67 seconds)	44	51.80%		39	68.40%		0.04
High risk	41	48.20%		18	31.60%
SPPB – cutoff: 11 points
Low risk (< 11 points)	39	45.90%		35	61.40%		0.07
High risk	46	54.10%		22	38.60%

Variable	Meaning	With cataract (n = 85)		Without cataract (n = 57)

		p-value	OR	p-value	OR
Age 75 years or older	No
Age 75 years or older	Yes	0.58	1.34	0.68	1.40
Sex	Male
Sex	Female	0.02*	5.60	0.74	0.83
Absence of spouse	No
Absence of spouse	Yes	0.02*	2.90	0.51	1.42
Diagnosis of cataract	No
	Yes
Uses psychotropic	No
Uses psychotropic	Yes	0.08**	3.73	0.17**	4.94
Polypharmacy (3 or more)	No
Polypharmacy (3 or more)	Yes	0.05*	2.52	0.79	0.87
Multimorbidity	No
Multimorbidity	Yes	0.39	1.58	0.06**	3.36
Katz index	Independence on ADL	0.02*	4.14	0.74	0.82
Lawton scale	Independence on IADL	0.06**	0.87	0.32	1.15
Risk of falls (BBS)	Low risk of falls	0.34	0.60	0.73	1.24
Risk of falls (BBS)	High risk of falls	0.04*	3.73	0.23	0.72
TUG	Time in seconds	0.40	1.07	0.53	1.14
Risk of falls (cutoff on TUG: 7.67 seconds)	Low risk of falls
Risk of falls (cutoff on TUG: 7.67 seconds)	High risk of falls	0.17**	1.85	0.41	1.60
SPPB (cutoff: 11 points)	Low risk of falls
SPPB (cutoff: 11 points)	High risk of falls	0.02*	4.16	0.88	0.92
Level of physical activity	Active
Level of physical activity	Non-active	0.09**	2.11	0.05*	3.12

Model	With cataract	Variable	B	Standard error	Wald	p	OR
A	No	Age 75 years or older	0.76	1.06	0.52	0.47	2.15
		Sex	-0.35	0.79	0.2	0.66	0.71
		Multimorbidity (5 or more)	1.63	0.81	4.08	0.04*	5.1
		Psychotropic agent	1.61	1.23	1.71	0.19	5.01
		Constant	-0.46	0.74	0.39	0.54	0.63
B	Yes	Age 75 years or older	0.24	0.7	0.12	0.73	1.28
		Sex	1.49	0.65	5.22	0.02*	4.45
		Absence of spouse	0.62	0.53	1.36	0.24	1.85
		Polypharmacy (3 or more)	0.85	0.54	2.47	0.12	2.34
		Physical performance (< 11 on SPPB)	1.26	0.6	4.48	0.03*	3.53
		Recommended level of physical activity	-0.08	0.58	0.02	0.89	0.92
		Constant	-3.04	0.73	17.13	0.01	0.05

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[1] Collaborations

LL Borges, LPS Paz and RL Menezes performed the field work and the latter author served as the adviser of the study. LPS Paz, LL Borges, VRFS Marães, MMF Gomes, MM Bachion and RL Menezes participated in the final draft of the manuscript.