Abstract
Purpose :
People with visual impairments are at risk of poor mental health. This study investigated the prevalence of mental health conditions and associations in people with macular disease.
Methods :
A cross-sectional survey was conducted among people with macular disease in Australia. Participants were recruited from Macular Disease Foundation Australia membership and through social media advertisements. The survey included standard mental health (MH) scales: Geriatric Depression Scale (GDS-15), Generalized Anxiety Disorder scale (GAD-7), UCLA-Loneliness scale (UCLA-LS) and the Lubben Social Network Scale–6 (LSNS-6). Associations between depressive symptoms (GDS-15>5) and anxiety (GAD-7>4) and predictor variables of socio-demographic factors, self-reported vision, diagnosis of neovascular AMD, systemic and ocular co-morbidities, social isolation (LSNS-6<12), loneliness (UCLA-LS>5), concerns about falling, worry about scams and sleep quality were explored in multivariable logistic regression analyses.
Results :
A total of 1969 participants completed the survey. A majority were female (68%) and most were 75 years or older (75%). Age-related macular degeneration was the most common eye condition (67%), with 26% reporting neovascular AMD in at least one eye. As per the MH scales, 16% had depressive symptoms, 21% had anxiety symptoms, 21% were lonely and 22% socially isolated. Of those screening positive for depression and moderate/severe anxiety, 56% and 50% were not receiving any mental health support. Fair/worse self-rated vision [multivariable-adjusted OR:4.19 (95% CI:2.28-7.70)], loneliness [3.42 (2.03-5.76)], social isolation [3.44 (2.0-5.91)], concerns about falling [2.92 (1.57-3.34)], poor sleep quality [2.42 (1.45-4.04)] and anxiety [8.48 (4.97-14.48)] were associated with increased odds of depressive symptoms. Age <75 years [multivariable-adjusted OR: 2.62 (95% CI:1.68-4.09)], loneliness [3.76 (2.33-6.07)], concerns about falling [1.59 (1.17-2.15)], poor sleep quality [2.28 (1.48-3.50] and depression [7.39 (4.36-12.54)] were associated with increased odds of anxiety symptoms. Counterintuitively fair/worse vision [0.55 (0.34-0.88)] was protective against anxiety.
Conclusions :
Depressive symptoms are four times more prevalent in people with macular disease when vision is impaired. Symptoms of depression and anxiety often co-occur. Many experiencing these symptoms were not receiving MH care, indicating the need for increasing awareness and MH support.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.