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Falls and health status in elderly women following first eye cataract surgery: a randomised controlled trial

R H Harwood^1,*, A J E Foss^2,*, F Osborn², R M Gregson², A Zaman² and T Masud³

¹ Health Care of the Elderly, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK
² Department of Ophthalmology, University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK
³ Clinical Gerontology Research Unit, City Hospital, Nottingham NG5 3PB, UK

Correspondence to:
Correspondence to:
Rowan Harwood or Alexander Foss
University Hospital, Queen’s Medical Centre, Nottingham NG7 2UH, UK; rowan.harwood{at}ntlworld.com or alexander.foss{at}btinternet.com

Background/aim: A third of elderly people fall each year. Poor vision is associated with increased risk of falls. The authors aimed to determine if first eye cataract surgery reduces the risk of falling, and to measure associated health gain.

Methods: 306 women aged over 70, with cataract, were randomised to expedited (approximately 4 weeks) or routine (12 months wait) surgery. Falls were ascertained by diary, with follow up every 3 months. Health status was measured after 6 months.

Results: Visual function improved in the operated group (corrected binocular acuity improved by 0.25 logMAR units; 8% had acuity worse than 6/12 compared with 37% of controls). Over 12 months of follow up, 76 (49%) operated participants fell at least once, and 28 (18%) fell more than once. 69 (45%) unoperated participants fell at least once, 38 (25%) fell more than once. Rate of falling was reduced by 34% in the operated group (rate ratio 0.66, 95% confidence interval 0.45 to 0.96, p = 0.03). Activity, anxiety, depression, confidence, visual disability, and handicap all improved in the operated group compared with the control group. Four participants in the operated group had fractures (3%), compared with 12 (8%) in the control group (p = 0.04).

Conclusion: First eye cataract surgery reduces the rate of falling, and risk of fractures and improves visual function and general health status.

Abbreviations: HADS, Hospital Anxiety and Depression Scale; LHS, London Handicap Scale; MMSE, Mini Mental State Examination

Keywords: health status; falls; elderly women; cataract; surgery

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