Falls and Fractures in Patients with Geographic Atrophy: A US Claims Data Analysis.

INTRODUCTION

The increased risk of falls in elderly people represents a substantial public health burden that may be compounded by impaired visual acuity. The present study aimed to assess the independent risk of incident falls and fractures in patients with geographic atrophy (GA).

METHODS

This retrospective, noninterventional, cohort study analyzed three US claims datasets (Optum's de-identified Clinformatics® Data Mart Database [Clinformatics®], Merative™ MarketScan® Commercial and Medicare Databases [MarketScan], and IQVIA US PharMetrics® [PharMetrics]). Patients were defined as having at least one International Classification of Diseases, Tenth Revision code (H35.31x3, H35.31x4) for GA. A propensity score-matched control cohort, matched on age, sex, index year, and disease history, was also included. Relative risks (RRs) for incident falls, fractures, and health care resource utilization (HCRU) were calculated between GA and control cohorts.

RESULTS

The Clinformatics®, MarketScan, and PharMetrics datasets included 44,591, 9470, and 27,428 patients with GA, respectively. Across the three databases, mean (SD) age ranged from 75.9 (8.3) to 80.5 (7.2) years, and 61% to 64% were female. The largest subgroup was patients with bilateral GA without subfoveal involvement (35-37%), followed by unilateral GA without subfoveal involvement (23-24%). Risks of falls (RR 1.16-1.36) and fractures (RR 1.17-1.29) in the 4 years following the index date were higher in patients with GA compared with controls. Patients with bilateral GA and subfoveal involvement had the most pronounced increase in risk of falls (RR 1.42-1.49) and fractures (RR 1.33-1.45). Compared to controls, patients with GA also had an increased risk for hospitalization (RR 1.18-1.27), emergency department visits (RR 1.18-1.21), nursing home or assisted living admissions (RR 1.06-1.28), and outpatient visits (RR 1.05-1.08).

CONCLUSION

GA represents an independent risk factor for falls, fractures, and higher HCRU. These data reveal the substantial public health burden of GA associated with the management of falls and fractures.