Abstract
This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment.
Highlights
Age-related eye disease and associated visual impairment is estimated to affect over 372 million older adults globally, or 27.8% of older adults (World Health Organization, 2012), and this number is expected to rise with projected increases in the aging population (Ruiz-Moreno et al, 2007)
The Goldberg Anxiety and Depression (GAD) scales were originally validated in a young population (Goldberg et al, 1988) and recent data from Australian samples suggest that the average number of reported symptoms of depression and anxiety differ with gender and age cohort (Jorm et al, 2005)
We examined the prevalence of self-reported comorbid eye disease, visual function status and depressive and anxiety symptoms in a community based sample of 662 older adults
Summary
Age-related eye disease and associated visual impairment is estimated to affect over 372 million older adults globally, or 27.8% of older adults (World Health Organization, 2012), and this number is expected to rise with projected increases in the aging population (Ruiz-Moreno et al, 2007). The rate of depression increases with age, it is 1.25–2.92 times higher for older adults with vision impairment (Hayman et al, 2007; Noran et al, 2009; Li et al, 2011), and age-related eye diseases such as cataract (Fagerstrom, 1994; McGwin et al, 2003; Freeman et al, 2009), glaucoma (Wilson et al, 2002; Mabuchi et al, 2012; Tosini et al, 2012) and macular degeneration (Brody et al, 2001; Casten et al, 2004; Tolman et al, 2005; Mathew et al, 2011). A clear understanding of the contributors to depression and anxiety in older adults with visual impairment has implications for treatment and public health
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