Quantifying Fall-Related Hazards in the Homes of Persons with Glaucoma.
Yonge Andrea V, Swenor Bonnielin K, Miller Rhonda, Goldhammer Victoria, West Sheila K, Friedman David S, Gitlin Laura N, Ramulu Pradeep Y
AI Summary
This study found numerous fall hazards in glaucoma patients' homes, with worse vision not correlating with fewer hazards. This suggests patients don't adapt homes, highlighting a need for hazard-reduction interventions.
Abstract
Objective
To characterize fall-related hazards in the homes of persons with suspected or diagnosed glaucoma, and to determine whether those with worse visual field (VF) damage have fewer home hazards.
Design
Cross-sectional study using baseline (2013-2015) data from the ongoing Falls in Glaucoma Study (FIGS).
Participants
One-hundred seventy-four of 245 (71.0%) FIGS participants agreeing to the home assessment.
Methods
Participants' homes were assessed using the Home Environment Assessment for the Visually Impaired (HEAVI). A single evaluator assessed up to 127 potential hazards in 8 home regions. In the clinic, binocular contrast sensitivity (CS) and better-eye visual acuity (VA) were evaluated, and 24-2 VFs were obtained to calculate average integrated VF (IVF) sensitivity.
Main outcome measures
Total number of home hazards.
Results
No significant visual or demographic differences were noted between participants who did and did not complete the home assessment (P > 0.09 for all measures). Mean age among those completing the home assessment (n = 174) was 71.1 years, and IVF sensitivity ranged from 5.6 to 33.4 dB (mean = 27.2 dB, standard deviation [SD] = 4.0 dB). The mean number of items graded per home was 85.2 (SD = 13.2), and an average of 32.7 (38.3%) were identified as hazards. IVF sensitivity, CS, and VA were not associated with total home hazards or the number of hazards in any given room (P > 0.06 for all visual measures and rooms). The bathroom contained the greatest number of hazards (mean = 7.9; 54.2% of graded items classified as hazardous), and the most common hazards identified in at least 1 room were ambient lighting <300 lux and exposed light bulbs. Only 27.9% of graded rooms had adequate lighting. IVF sensitivity, CS, and VA were not associated with home lighting levels (P > 0.18 for all), but brighter room lighting was noted in the homes of participants with higher median income (P < 0.001).
Conclusions
Multiple home fall hazards were identified in the study population, and hazard numbers were not lower for persons with worse VF damage, suggesting that individuals with more advanced glaucoma do not adapt their homes for safety. Further work should investigate whether addressing home hazards is an effective intervention for preventing falls in this high-risk group.
MeSH Terms
Shields Classification
Key Concepts5
In a cross-sectional study of 174 participants with suspected or diagnosed glaucoma, an average of 32.7 (38.3%) of 85.2 graded items per home were identified as fall-related hazards using the Home Environment Assessment for the Visually Impaired (HEAVI).
In a cross-sectional study of 174 participants with suspected or diagnosed glaucoma, integrated visual field (IVF) sensitivity, binocular contrast sensitivity (CS), and better-eye visual acuity (VA) were not associated with the total number of home hazards or the number of hazards in any given room (P > 0.06 for all visual measures and rooms).
In a cross-sectional study of 174 participants with suspected or diagnosed glaucoma, the bathroom contained the greatest number of fall-related hazards (mean = 7.9; 54.2% of graded items classified as hazardous), and the most common hazards identified in at least 1 room were ambient lighting <300 lux and exposed light bulbs.
In a cross-sectional study of 174 participants with suspected or diagnosed glaucoma, integrated visual field (IVF) sensitivity, binocular contrast sensitivity (CS), and better-eye visual acuity (VA) were not associated with home lighting levels (P > 0.18 for all), but brighter room lighting was noted in the homes of participants with higher median income (P < 0.001).
In a cross-sectional study of 174 participants with suspected or diagnosed glaucoma, the mean age was 71.1 years, and integrated visual field (IVF) sensitivity ranged from 5.6 to 33.4 dB (mean = 27.2 dB, standard deviation [SD] = 4.0 dB).
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