Cataract and the increased risk of depression in general population: a 16-year nationwide population-based longitudinal study

Abstract

Cataract is the primary cause of visual impairment and can be corrected by cataract surgery. We investigated the impact of cataract on the risk of depression along with the benefits of cataract surgery. Patients newly diagnosed with cataract by ophthalmologists between 2001 and 2015 were identified from the National Health Insurance Research Database (NHIRD) in Taiwan. Non-cataract individuals were recruited by 1:1 matching for age, sex and index year. After propensity score matching, 233,258 patients in total were included in our study: 116,629 in each of the cataract and non-cataract cohorts. The primary outcome was the new diagnosis of depression by psychiatrists. In a mean follow-up period of 7.8 years, cataract was significantly associated with increased risk of developing depression (adjusted hazard ratio [aHR] = 1.78, 95% confidence interval [CI] 1.70–1.87, p < 0.001). We further divided the cataract cohort into surgery and non-surgery groups. Notably, cataract surgery group was associated with a decreased risk of depression compared with non-surgery patients (aHR = 0.75, 95% CI 0.71–0.79, p < 0.001). Our results emphasise the importance of regular screening for depression among cataract patients and the beneficial effect of cataract surgery in reducing the risk of depression.

Visual Impairment, Eye Disease, and the 3-year Incidence of Depressive Symptoms: The Canadian Longitudinal Study on Aging

“…Chen et al recently reported that a diagnosis of cataract was associated with a greater risk of incident depressive symptoms, both in those who had cataract surgery (HR = 1.65, 95% CI 1.54, 1.76) and in those who did not (HR = 2.14, 95% CI 2.03, 2.27). 16 Two crosssectional papers also support our findings. Eramudugolla et al found that the self-report of having or having had a cataract was associated with greater depressive symptoms (OR = 1.40, 95% CI 1.07, 1.81).…”

“…To further describe the association with cataract, age and sex-stratified analyses are presented in Table 3. Like Chen et al, 16 no differences by age or sex were found.…”

“…Currently having a cataract in the eye, as measured using the Lens Opacities Classification System III scheme, was associated with depressive symptoms (OR = 1.33, 95% CI 1.08, 1.70) after adjusting for age, sex, education level, monthly income, living alone, smoking, alcohol intake, tea consumption, sleeping hours per day and presenting visual acuity in a community-based sample (n = 4,611) of Chinese adults aged > 60 years. Chen et al 16 Longitudinal In a population-based study of patients identified through the National Health Insurance Research Database in Taiwan (n = 233,258), cataract patients were found to have an increased risk of developing a new diagnosis of depression (HR = 1.72, 95% CI 1.64-1.80) after adjusting for age, sex, income and comorbidities as compared with non-cataract individuals. The risk was elevated both in those who had surgery (HR = 1.65, 95% CI 1.54, 1.76) and in those who did not (HR = 2.14, 95% CI 2.03, 2.27) compared to those without cataract.…”

“…Some longitudinal studies, which can establish temporality, have been done although the results are somewhat conflicting. [11][12][13][14][15][16] For example, five studies have found that visual impairment is not associated with incident depressive symptoms ,1117-20 while five other studies have reported a positive association. 12,13,[21][22][23] Furthermore, few of the longitudinal studies have examined effect modifiers to indicate whether some groups of people are at a greater risk of depressive symptoms after losing vision than others.…”

Biological, Psychological, and Social Determinants of Depression: A Review of Recent Literature

“…A number of studies examined the links between the outcome of depression and physical health-related factors, such as bladder outlet obstruction, cerebral atrophy, cataract, stroke, epilepsy, body mass index and obesity, diabetes, urinary tract infection, forms of cancer, inflammatory bowel disorder, glaucoma, acne, urea accumulation, cerebral small vessel disease, traumatic brain injury, and disability in multiple sclerosis [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , ...…”