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Alyssa Grant, Marie-Josée Aubin, Ralf Buhrmann, Ellen E Freeman; Visual impairment, eye disease, and the 3-year incidence of depression: The Canadian Longitudinal Study on Aging. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2659.
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Older adults with visual impairment (VI) are more likely to have depression compared to those with normal vision although much of the research examining this association has been cross-sectional. Our goal was to explore the longitudinal association between vision-related variables and incident depression in a community-dwelling sample of older adults and to examine whether sex, marital status, or hearing loss act as effect modifiers.
A 3-year prospective cohort study was performed using data from the Canadian Longitudinal Study on Aging consisting of 30,097 individuals aged 45-85 years. Visual acuity was evaluated with habitual distance correction using an illuminated Early Treatment of Diabetic Retinopathy Study chart. VI was defined as binocular presenting visual acuity worse than 20/40. Incident depression was defined using a cut-off score of 10 or greater on the Center for Epidemiologic Studies Depression scale in those who did not have depression at baseline. Participants were asked if they had a physician diagnosis of macular degeneration, glaucoma, or cataract, and whether the cataract was still present. Participants also rated their hearing. Multivariable Poisson regression was used with vision-related variables entered into separate models. Sampling weights were included to adjust for the complex survey design.
Of 22,558 participants without depression at baseline, 1,807 (8.0%) developed depressive symptoms within 3 years. Macular degeneration and having had cataract surgery were associated with incident depression (relative risk (RR)=1.28, 95% confidence interval (CI) 1.02, 1.61 and RR=1.30, 95% CI 1.05, 1.62, respectively) after adjusting for age, sex, income, education, partner status, smoking, level of comorbidity, and province. Having a current cataract in the eye was not related to incident depression overall (RR=1.00, 95% CI 0.79, 1.26) but it was in those with hearing loss (RR=1.71, 95% CI 1.07, 2.73). VI and glaucoma were not associated with incident depression (P=0.815 and P=0.215, respectively).
Those reporting macular degeneration, cataract surgery, or cataract in conjunction with hearing loss had a higher risk of becoming depressed. These data highlight the need for screening and targeted interventions to treat depressive symptoms among the identified high risk groups.
This is a 2020 ARVO Annual Meeting abstract.
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