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Timothy V. Johnson, Robin Casten, Barry Rovner, William S. Tasman; Natural History And Predictors Of Incident Depression In Patients With Age-related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5181.
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Despite a 30% prevalence rate, predictors of incident depression among patients with age-related macular degeneration (AMD) remain unknown. We hypothesized that visual acuity and visual function would predict incident depression in AMD patients.
This prospective study followed 83 patients diagnosed with AMD without depression at baseline. Patients were assessed at baseline for demographics, medical comorbidities, activities of daily living (ADLs), near and distance vision, and visual function. Every two weeks, patients were assessed for depression using the Geriatric Depression Scale (GDS). Multivariate binary logistic regression analysis assessed predictors of incident depression, defined as GDS > 5 at any point over the six month study period.
Twenty patients (24.1%) had a GDS > 5 at least once. Among these 20 patients, mean (SD) length of depressive symptoms 10 (4) weeks. The minimum and maximum lengths of depression were 2 and 26 weeks, respectively. Multivariate regression analysis identified functional impairment, as measured by the Community Disability Scale, as a significant predictor of incident depression (OR: 1.096, 95% CI: 1.014-1.185). Near vision (p=0.884) and distance vision (p=0.307) were not independent predictors of depression.
Many patients with AMD develop depression. In contrast to expectations, severity of vision loss was not predictive of depression. The best predictor was level of physical disability. Ophthalmologists should screen for depression in patients with AMD and functional disability to identify this high-risk group of patients with AMD.
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