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

Abstract

Purpose: Our goal was to explore the longitudinal association between vision-related variables and incident depressive symptoms in a community-dwelling sample of older adults and to examine whether sex, education, or hearing loss act as effect modifiers. Methods: 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. Visual impairment was defined as binocular presenting visual acuity worse than 20/40. Incident depressive symptoms was defined using a cutoff score of 10 or greater on the Center for Epidemiologic Studies Depression scale. Participants were asked if they had ever had a physician diagnosis of age-related macular degeneration (AMD), glaucoma, or cataract. Multivariable Poisson regression was used. Results: Of 22,558 participants without depressive symptoms at baseline, 7.7% developed depressive symptoms within 3 years. Cataract was associated with incident depressive symptoms (relative risk = 1.20, 95% confidence interval 1.05, 1.37) after adjusting for age, sex, income, education, partner status, smoking, level of comorbidity, hearing loss, and province. Visual impairment, AMD, and glaucoma were not associated with incident depressive symptoms. No effect modification was detected. Conclusions: Our longitudinal data confirm that the risk of depressive symptoms is higher in those who report ever having a cataract. Further research should confirm this and interventions should be considered.

Impact of the Improper Adjustment for Age in Research on Age-Related Macular Degeneration: An Example Using Data from the Canadian Longitudinal Study on Aging

“…5 The full methods and results on the association of visual impairment, eye disease, and the incidence of depressive symptoms are published in another paper. 6…”

The association between cataract surgery and mental health in older adults: a review

“…Several studies have assessed anxiety or depression in cataract patients 2 , 4 , 12 – 23 (Table 1 ). These studies consistently indicate that cataract patients experience more severe anxiety and depression compared to healthy individuals.…”

Association of vision and hearing status with depressive symptoms among middle-aged and older Chinese adults

“…Our results revealed that participants with only vision impairments, only hearing impairments, and both vision and hearing impairments presented with depressive symptoms but with a different degree of risk. Several population-based longitudinal studies in Canada ( 25 ), the Salisbury Eye Evaluation Study ( 26 ), and the National Health and Aging Trends Study ( 27 ) confirmed a link between depressive symptoms and vision impairments. A prevailing concern among hearing-impaired individuals in China is the impact of hearing impairments on physical and mental health ( 23 , 28 ).…”

“…Indeed, the Korean health insurance cohort study ( 29 ) reported that severe hearing impairments significantly increased the risk of depressive symptoms in all age groups of the study population after matching for age, sex, income, and region. A population-based longitudinal study reported that vision and hearing impairments were significantly associated with depressive symptoms and suggested that treating or rehabilitating either vision or hearing impairments may incident depressive symptoms ( 25 , 30 , 31 ). According to several prospective studies, the presence of depressive symptoms is associated with reduced sensory function, and the risk of depressive symptoms increases over subsequent years ( 28 , 32 ).…”