시력과 낙상: 국민건강 영양 조사 2008-2012
Visual Acuity and Falls in South Korea: Korean National Health and Nutrition Examination Survey 2008-2012
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초록
목적: 시력 및 안질환과 낙상과의 관계를 밝히고자 하였다. 대상과 방법: 2008년부터 2012년까지 국민건강영양조사를 완료한 19세 이상 성인 28,899명을 대상으로 양안 중 최대교정 시력이 좋은 눈 혹은 최대교정 시력이 나쁜 눈의 시력과 동반 안질환이 낙상에 미치는 영향을 다변량 회귀분석을 이용하여 분석하였다. 고려한 독립변수로는 사회인구통계학적인 요인, 동반질환(고혈압, 당뇨, 관절염, 심근경색 혹은 협심증, 뇌졸중)을 고려하였다. 시력은 1.0, 0.8, 0.5-0.63, <0.5로 4단계로 분류하였다. 결과: 낙상경험이 있는 대상자는 28,899명 중 총 511명이었다. 다변량 분석에서 시력이 좋은 눈의 낮은 시력과 낙상은 관련이 있었는데, 좋은 눈의 시력이 1인 군을 기준으로 0.8인 군 대응비 1.31 (95% 신뢰구간 1.00-1.72), 0.5-0.63인 군 대응비 1.86 (95% 신뢰구간 1.07-3.24), <0.5군 대응비 1.21 (95% 신뢰구간 0.58-2.54)로 낙상의 위험을 높였다(p=0.025 for trend). 시력이 나쁜 눈의 시력 정도는 낙상과 관련이 없었다. 초기 황반변성은 단변량 분석(대응비 2.24) 및 나이 성별을 보정한 분석(대응비 1.52)에서 낙상의 위험을 높였으나, 다변량 분석에서는 유의한 결과는 아니었다. 연령별로 하위분석을 하였을 때, 50세 미만의 비교적 젊은 군에서는 시력이 1.0인 정상군에 비해 시력이 0.5-0.63인 군의 낙상위험이, 대응비 5.83 (95% 신뢰구간 1.58-21.54)으로 높았으며, 50세 이상 70세 미만 군에서 시력이 낮을수록 낙상이 많은 경향성(p=0.033 for trend)을 확인하였으나, 70세 이상의 고령에서는 시력과 낙상은 무관하였다. 결론: 시력은 낙상의 유의한 예측인자로, 낙상 예방을 위해 고려해야 할 요인이다.
Abstract
Purpose: To assess the influence of visual acuity (VA) and ocular condition on falls. Methods: We analyzed 28,899 Korean adults using cross-sectional data from the Korean National Health and Nutrition Examination Survey (2008-2012). Associations between best corrected VA based on better or worse seeing eye and ocular condition and falls were identified using multivariable logistic regression. We included sociodemographic factors and comorbidities including hypertension, diabetes, arthritis, acute myocardial infarction/angina, and stroke as independent variables. VA was divided into 1.0, 0.8, 0.5-0.63, and <0.5. Results: Among 28,899 subjects, falls occurred in 511. In multivariable logistic regression analysis, low VA based on the better seeing eye was significantly associated with falls (VA 1.0 as a reference group; adjusted odds ratio [aOR] = 1.31, 95% confidence interval [CI], 1.00-1.72 in VA of 0.8; aOR = 1.86, 95% CI, 1.07-3.24 in VA of 0.5-0.63; and aOR = 1.21, 95% CI, 0.58-2.54 in VA of <0.5; p = 0.025 for trend). There was no association between VA based on the worse seeing eye and falls. Early age-related macular degeneration was associated with falls in univariable analysis (OR = 2.24) and age- and sex-adjusted analysis (aOR = 1.52), but not in multivariable analysis. In terms of age subgroups, subjects with VA of 0.5-0.63 were more likely to have experienced falls compared with subjects with VA of 1.0 (aOR = 5.83, 95% CI, 1.58-21.54) among subjects 50 years of age or younger. An increasing trend of falls with decreasing VA among subjects between 50 and 70 years of age was observed (p = 0.033 for trend). However, no such association was observed in elderly subjects ≥70 years of age. Conclusions: VA should be considered for preventing falls because lower VA is associated with increased risk of falls.
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