Cataract and the increased risk of depression in general population: a 16-year nationwide population-based longitudinal study

Ching-Hui Loh,Jen-Hung Wang,Po-Wei Chen,Peter Pin-Sung Liu,Shu-Man Lin,Huei-Kai Huang

doi:10.1038/s41598-020-70285-7

Ching-Hui Loh, Jen-Hung Wang + Show 4 more

Open Access

https://doi.org/10.1038/s41598-020-70285-7

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Abstract

Cataract is the primary cause of visual impairment and can be corrected by cataract surgery. We investigated the impact of cataract on the risk of depression along with the benefits of cataract surgery. Patients newly diagnosed with cataract by ophthalmologists between 2001 and 2015 were identified from the National Health Insurance Research Database (NHIRD) in Taiwan. Non-cataract individuals were recruited by 1:1 matching for age, sex and index year. After propensity score matching, 233,258 patients in total were included in our study: 116,629 in each of the cataract and non-cataract cohorts. The primary outcome was the new diagnosis of depression by psychiatrists. In a mean follow-up period of 7.8 years, cataract was significantly associated with increased risk of developing depression (adjusted hazard ratio [aHR] = 1.78, 95% confidence interval [CI] 1.70–1.87, p < 0.001). We further divided the cataract cohort into surgery and non-surgery groups. Notably, cataract surgery group was associated with a decreased risk of depression compared with non-surgery patients (aHR = 0.75, 95% CI 0.71–0.79, p < 0.001). Our results emphasise the importance of regular screening for depression among cataract patients and the beneficial effect of cataract surgery in reducing the risk of depression.

Highlights

Cataract is the primary cause of visual impairment and can be corrected by cataract surgery
280,970 participants were included in our study, with 140,485 participants in each of the cataract and non-cataract cohorts following 1:1 matching based on age, sex and index year
The aHR increased to 2.14 for cataract patients who did not undergo surgery compared with non-cataract individuals

Summary

Introduction

Cataract is the primary cause of visual impairment and can be corrected by cataract surgery. 233,258 patients in total were included in our study: 116,629 in each of the cataract and non-cataract cohorts. In a mean follow-up period of 7.8 years, cataract was significantly associated with increased risk of developing depression (adjusted hazard ratio [aHR] = 1.78, 95% confidence interval [CI] 1.70–1.87, p < 0.001). Cataract surgery group was associated with a decreased risk of depression compared with non-surgery patients (aHR = 0.75, 95% CI 0.71–0.79, p < 0.001). Depression is associated with functional impairment, risk of dementia, and increased mortality[2]. A recent nationwide cohort study indicated a longitudinal association between visual impairment and depressive s ymptoms[10]. The leading cause of visual impairment and blindness in the elderly is cataract[11], studies comparing the risk of depression between. Cataract patients and healthy individuals are still limited and are either mixed anxiety and depression together[12], or have selection bias[13]

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