Abstract
Purpose :
As a chronic disease, glaucoma could put patients at higher risk for major depressive disorder (MDD) and anxiety, conditions associated with medical treatment noncompliance. We performed a cross-sectional study to examine the association between glaucoma and MDD, dysthymic disorder, and anxiety states in the elderly US California (CA) Medicare population, respectively.
Methods :
This study inspected US CA Medicare beneficiaries from the 2015 part B carriers claims databases attained from the Centers for Medicare and Medicaid Services (CMS). The inclusion criteria were patients who resided in CA during 2015, were 65 years or older, had Medicare part A and part B coverage, and had at least one part B claim in 2015. The exposure included all glaucoma subtypes defined by the International Classification of Diseases, 9th or 10th Revision diagnosis codes. The outcomes of interest were single episode and recurrent MDD, dysthymic disorder, and anxiety states identified by the ICD-9-CM/ICD-10-CM diagnosis codes in any claim. Potential confounders included age, sex, race/ethnicity, and Charlson Comorbidity Index scores. The unadjusted associations between glaucoma and each mental illness were evaluated using Chi-squared tests, and the adjusted associations were assessed using logistic regression models, adjusting for all potential confounders described above.
Results :
Among 2,574,641 CA Medicare patients who met inclusion criteria, the overall prevalence of glaucoma was 8.3% (n=213,067). Those with glaucoma had an increased adjusted odds of single episode MDD (odds ratio [OR]=1.08, 95% confidence interval [CI]:1.06-1.09), recurrent MDD (OR=1.16, 95% CI:1.13-1.19), dysthymic disorder (OR=1.11, 95% CI:1.06-1.16), and anxiety (OR=1.10, CI 95%:1.08-1.12) compared to those without glaucoma. All comparisons had a p<0.001.
Conclusions :
This study identified a statistically significant association between glaucoma and mental illnesses of major depressive disorder, dysthymic disorder, and anxiety states in the senior citizen CA Medicare population. This association highlights the need for further study of the medical and social aspects that drive its existence.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.