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Manhattan Vision Screening and Follow-up Study (NYC-SIGHT): a nested cross-sectional assessment of falls risk within a cluster randomised trial
  1. Lisa A Hark1,2,
  2. Yujia Wang2,
  3. Prakash Gorroochurn3,
  4. Phyllis R Simon4,
  5. Stefania C Maruri2,
  6. Desiree R Henriquez2,
  7. Daniel F Diamond1,2,
  8. Jason D Horowitz1,2,
  9. Lisa Park1,2,
  10. Qing Wang1,2,
  11. James D Auran1,2,
  12. Jailine Carrion2,
  13. David S Friedman5,
  14. Jeffrey L Liebmann1,2,
  15. George A Cioffi1,2,
  16. Noga Harizman1,2
  1. 1Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
  2. 2Edward S Harkness Eye Institute, New York, NY, USA
  3. 3Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA
  4. 4Occupational Therapy, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
  5. 5Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
  1. Correspondence to Dr Lisa A Hark, Ophthalmology, Columbia University Vagelos College of Physicians and Surgeons, New York, New York, USA; lah112{at}cumc.columbia.edu

Abstract

Background To investigate the feasibility of using the Stopping Elderly Accidents, Deaths and Injuries (STEADI) Falls Risk Tool Kit during community-based eye health screenings to assess falls risk of participants enrolled in the Manhattan Vision Screening and Follow-Up Study (NYC-SIGHT).

Methods Cross-sectional analysis of data from a 5-year prospective, cluster-randomised clinical trial conducted in affordable housing developments in New York City in adults age 40 years and older. Prescreening questions determined whether participants were at risk of falling. STEADI tests classified participants at low, moderate or high risk of falling. Multivariate logistic regression determined odds of falls risk of all enrolled participants.

Results 708 participants completed the eye health screening; 351 (49.6%) performed STEADI tests; mean age: 71.0 years (SD±11.3); 72.1% female; 53.6% Black, non-Hispanic, 37.6% Hispanic/Latino. Level of falls risk: 32 (9.1%) low, 188 (53.6%) moderate and 131 (37.3%) high. Individuals age >80 (OR 5.921, 95% CI (2.383 to 14.708), p=0.000), had blurry vision (OR 1.978, 95% CI (1.186 to 3.300), p=0.009), high blood pressure (OR 2.131, 95% CI (1.252 to 3.628), p=0.005), arthritis (OR 2.29876, 95% CI (1.362 to 3.875), p=0.002) or foot problems (OR 5.239, 95% CI (2.947 to 9.314), p=0.000) had significantly higher odds of falling, emergency department visits or hospitalisation due to falling.

Conclusion This study detected a significant amount of falls risk in an underserved population. The STEADI Falls Risk screening questions were easy for eye care providers to ask, were highly predictive of falls risk and may be adequate for referral to occupational health and/or physical therapy.

  • Epidemiology
  • Glaucoma
  • Public health
  • Telemedicine

Data availability statement

Data are available on reasonable request.

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Data availability statement

Data are available on reasonable request.

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Footnotes

  • Contributors LAH: study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, preparation of manuscript, funding acquisition, and final responsibility of the manuscript. YW: acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. PG: study concept and design, analysis and interpretation of data, and preparation of manuscript. PRS: study concept and design, acquisition of subjects and/or data, and preparation of manuscript. SCM: acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. DRH: acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. JC: acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. DFD: acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. JDH: study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript. LP: study concept and design, analysis and interpretation of data, and preparation of manuscript. QW: analysis and interpretation of data, and preparation of manuscript. JDA: study concept and design, preparation of manuscript. DSF: study concept and design, analysis and interpretation of data, and preparation of manuscript, funding acquisition. JLL: study concept and design, analysis and interpretation of data, and preparation of manuscript, funding acquisition. GAC: study concept and design, acquisition of subjects and/or data, analysis and interpretation of data, and preparation of manuscript, funding acquisition. NH: analysis and interpretation of data and preparation of manuscript. LAH is guarantor.

  • Funding US Centers for Disease Control and Prevention Cooperative Agreements: U01DP006435, U01DP006436. Vision Health Initiative, Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, Georgia. Research to Prevent Blindness. (RPB) (New York, NY) also provided ongoing support to Columbia Department of Ophthalmology.

  • Disclaimer The findings and conclusions in this report are those of the authors, and do not necessarily represent the official position of the US Centers for Disease Control and Prevention. The sponsor or funding organisation had no role in the design or conduct of this research.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.