title: Combined hearing and visual impairment and depression in a population aged 75 years and older.
abstract: BACKGROUND
  Depression is associated with both visual and hearing impairment. Little is known about the relationship between combined hearing and visual impairment and mood in this age group. The aim of this population-based study was to investigate the association between functional sensory impairment, especially combined sensory impairment and depressive symptoms and depression diagnosed according to the DSM-IV criteria.
  
  
  METHODS
  The study group consisted of 470 adults, population-based sample, aged 75 years or older. We used the Snellen eye charts with E-letters and reading charts to evaluate the functional visual acuity. The ability to conduct a face-to-face conversation, the hearing aid use and the self-reported hearing problems were used to assess the functional hearing acuity. Depression was identified with two different methods. A geriatrician interviewed the subjects and the DSM-IV checklist was used to determine whether they met the criteria for major depression. The Zung Depression Status Inventory (DSI) was used to identify depressive symptoms. The cut off points of 40/80 and 48/80 in the DSI-score was used.
  
  
  RESULTS
  Seventy-two persons (15%) of the study population had depression diagnosed according to the DSM-IV criteria. Twelve per cent of subjects in the Functional Hearing Impairment (FHI) group, twenty per cent in the Functional Visual Impairment (FVI) group, eighteen per cent in the Combined Sensory Impairment (CSI) group and fifteen per cent in the Adequate Sensory Function (ASF) group suffered major depression. The differences between these groups were insignificant. The occurrence rates of the DSI score equal or over 40 points was 50% in the FHI group, 53% in the FVI group, 70% in the CSI group and 45% in the ASF group. The difference between the ASF group and sensory impairment group including FHI, FVI and CSI groups was statistically significant (p = 0.03).
  
  
  CONCLUSIONS
  Depressive symptoms, but not major depression, were common if elderly persons had combined sensory impairment.
authors.affiliation: Social and Welfare Health Center of Aänekoski, Aänekoski, Finland. taina.lupsakko@fimnet.fi
authors.forename: Taina
authors.initials: T
authors.lastname: Lupsakko
authors.forename: Maija
authors.initials: M
authors.lastname: Mäntyjärvi
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Raimo
authors.initials: R
authors.lastname: Sulkava
mesh_terms: D000368:Aged; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006311:Hearing Disorders / Q000453:epidemiology*; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D014786:Vision Disorders / Q000453:epidemiology*