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Risk of Musculoskeletal Injuries, Fractures, and Falls in Medicare Beneficiaries With Disorders of Binocular Vision

Risk of Musculoskeletal Injuries, Fractures, and Falls in Medicare Beneficiaries With Disorders... ImportanceDisorders of binocular vision are increasingly prevalent among fee-for-service Medicare beneficiaries 65 years or older. Visual impairment is a recognized risk factor for fractures. Despite the association of visual impairment and fracture risk, to our knowledge, no study has examined the influence that disorders of binocular vision (strabismus, amblyopia, diplopia, and nystagmus) may have on musculoskeletal injury and fracture risk in the elderly population. ObjectiveTo evaluate associations between disorders of binocular vision and musculoskeletal injury, fracture, and falls in the elderly. Design, Setting, and ParticipantsA retrospective study of 10-year (2002-2011) musculoskeletal injury, fracture, or fall prevalence in a 5% random sample of Medicare Part B fee-for-service claims for beneficiaries with disorders of binocular vision. Participants included Medicare beneficiaries living in the general community who were 65 years or older with at least 1 year of Medicare Part B enrollment. ExposuresDiagnosis of a disorder of binocular vision. Main Outcomes and MeasuresTen-year prevalence of musculoskeletal injury, fracture, or fall in individuals with and without disorders of binocular vision. Analyses were adjusted for age, sex, race/ethnicity, region of residence, systemic and ocular comorbidities, and duration of follow-up. ResultsThere were 2 196 881 Medicare beneficiaries identified. Of these, 99 525 (4.5%) had at least 1 reported disorder of binocular vision (strabismus, 2.3%; diplopia, 2.2%; amblyopia, 0.9%; and nystagmus, 0.2%). During the 10-year study period, there were 1 272 948 (57.9%) patients with documented musculoskeletal injury, fracture, or fall. The unadjusted odds ratio (OR) for the association between disorders of binocular vision and any of the 3 injury types was 2.23 (95% CI, 2.20-2.27; P < .001). The adjusted OR was 1.27 (95% CI, 1.25-1.29; P < .001). Conclusions and RelevanceMedicare beneficiaries with a disorder of binocular vision have significantly higher odds of sustaining a musculoskeletal injury, fracture, or fall. This finding is an important step forward in understanding and developing strategies to prevent these injuries, which are associated with high morbidity in the elderly. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Ophthalmology American Medical Association

Risk of Musculoskeletal Injuries, Fractures, and Falls in Medicare Beneficiaries With Disorders of Binocular Vision

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References (17)

Publisher
American Medical Association
Copyright
Copyright 2015 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6165
eISSN
2168-6173
DOI
10.1001/jamaophthalmol.2014.3941
pmid
25340322
Publisher site
See Article on Publisher Site

Abstract

ImportanceDisorders of binocular vision are increasingly prevalent among fee-for-service Medicare beneficiaries 65 years or older. Visual impairment is a recognized risk factor for fractures. Despite the association of visual impairment and fracture risk, to our knowledge, no study has examined the influence that disorders of binocular vision (strabismus, amblyopia, diplopia, and nystagmus) may have on musculoskeletal injury and fracture risk in the elderly population. ObjectiveTo evaluate associations between disorders of binocular vision and musculoskeletal injury, fracture, and falls in the elderly. Design, Setting, and ParticipantsA retrospective study of 10-year (2002-2011) musculoskeletal injury, fracture, or fall prevalence in a 5% random sample of Medicare Part B fee-for-service claims for beneficiaries with disorders of binocular vision. Participants included Medicare beneficiaries living in the general community who were 65 years or older with at least 1 year of Medicare Part B enrollment. ExposuresDiagnosis of a disorder of binocular vision. Main Outcomes and MeasuresTen-year prevalence of musculoskeletal injury, fracture, or fall in individuals with and without disorders of binocular vision. Analyses were adjusted for age, sex, race/ethnicity, region of residence, systemic and ocular comorbidities, and duration of follow-up. ResultsThere were 2 196 881 Medicare beneficiaries identified. Of these, 99 525 (4.5%) had at least 1 reported disorder of binocular vision (strabismus, 2.3%; diplopia, 2.2%; amblyopia, 0.9%; and nystagmus, 0.2%). During the 10-year study period, there were 1 272 948 (57.9%) patients with documented musculoskeletal injury, fracture, or fall. The unadjusted odds ratio (OR) for the association between disorders of binocular vision and any of the 3 injury types was 2.23 (95% CI, 2.20-2.27; P < .001). The adjusted OR was 1.27 (95% CI, 1.25-1.29; P < .001). Conclusions and RelevanceMedicare beneficiaries with a disorder of binocular vision have significantly higher odds of sustaining a musculoskeletal injury, fracture, or fall. This finding is an important step forward in understanding and developing strategies to prevent these injuries, which are associated with high morbidity in the elderly.

Journal

JAMA Ophthalmology – American Medical Association

Published: Jan 1, 2015

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