
Older patients who underwent cataract surgery have a lower risk of hip fractures, finds study published in JAMA.
Visual impairment has been found to be strongly associated with an increased risk of fractures, a significant cause of illness and death in the elderly population. "Specifically, vision plays an important role in providing a reference frame for postural balance and stability, and cataract-induced changes in vision have been found to be associated with postural instability," according to background information in the article. "Furthermore, cataracts have been found to be the most common cause of fracture-related visual impairment, with untreated cataract causing up to 49 percent of visual impairment in patients with femoral neck fractures related to decreased vision." Despite the association of poor vision and cataracts with increased fall and fracture risk, only a limited number of studies have examined the influence of cataract surgery on fall incidence in visually impaired adults.
Victoria L. Tseng, M.D., of the Warren Alpert Medical School of Brown University, Providence, R.I., and colleagues examined the association between cataract surgery and fracture incidence at 1-year. The study included a 5 percent random sample of Medicare Part B beneficiaries with cataract who received and did not receive cataract surgery from 2002 through 2009. Analyses were adjusted for various factors.
Osteoporosis was the most common fracture-related comorbidity (co-existing illness) (12.1 percent). The most common ocular comorbidity was glaucoma (19.1 percent).
"Cataract surgery may be associated with lower odds of subsequent fracture in patients aged 65 years and older in the U.S. Medicare population. Future prospective studies using standardized registries of patients with cataracts will help further elucidate the association between cataract surgery and fracture risk. Cataract surgery has already been demonstrated to be a cost-effective intervention for visual improvement, with an estimated cost per quality-adjusted life-year gained for cataract surgery in the first eye of $2,023 in the United States and $2,727 in the second eye. The results in this study suggest the need for further investigation of the additional potential benefit of cataract surgery as a cost-effective intervention to decrease the incidence of fractures in the elderly," the researchers conclude.
Source: Eurekalert