Risk of Falls, Fear of Falling, and Rates of Visual Field Progression in Glaucoma in the African Descent and Glaucoma Evaluation Study

Alexander F Dagi ¹, C Gustavo De Moraes ¹, Christopher A Girkin ²

⁰Bernard and Shirlee Brown Glaucoma Research Laboratory, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, New York.

Ophthalmology. Glaucoma +

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February 23, 2025

View abstract on PubMed

Summary

Faster glaucoma visual field progression is linked to increased fear of falling and a history of falls in patients of African and European descent. Rapid progressors were nearly threefold more likely to have fallen.

Area Of Science

Ophthalmology
Geriatrics

Background

Glaucoma is a leading cause of irreversible blindness worldwide.
Visual field (VF) loss in glaucoma is progressive and can impact patient mobility and quality of life.
Fear of falling (FoF) and a history of falls are common concerns in older adults, particularly those with vision impairment.

Purpose Of The Study

To investigate the association between the rate of glaucomatous visual field (VF) progression and fear of falling (FoF) and history of falls.
To examine these relationships across different ancestral groups.

Main Methods

A prospective, multicenter, longitudinal cohort study was conducted.
Patients with primary open-angle glaucoma were enrolled and assessed for VF progression using mean deviation (MD) over at least two years.
Validated questionnaires assessed fear of falling (FoF) and history of falls; statistical models adjusted for age, sex, and ancestry.

Main Results

Faster rates of MD progression were significantly associated with a history of falls (OR: 2.55) and worse FoF scores (β: 2.27).
Rapid progressors (MD slope < -0.5 dB/year) were 2.45 times more likely to report a history of falls.
No significant differences in fall history or FoF scores were observed between patients of African descent (AD) and European descent (ED).

Conclusions

Accelerated VF progression in glaucoma is a significant risk factor for both fear of falling and a history of falls.
These associations were consistent across ancestral groups, suggesting a universal impact of glaucoma progression on fall risk.
Ophthalmologists should consider fall risk assessment in glaucoma patients, especially those with rapid VF loss.

Keywords:

ADAGES Disparities Falls Glaucoma Visual field