title: Depression and the 25-item National Eye Institute Visual Function Questionnaire in older adults.
abstract: OBJECTIVE
  To examine the impact of depression in older adults on responses to the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) independent of demographics, vision, and general health.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  We took the opportunity of an ongoing study on older drivers to address the specific aim stated above. The recruitment population consisted of 6342 older adults (> or =60 years) who were licensed drivers residing in Birmingham, Alabama; who had been involved in a crash in the prior year, as identified by Alabama Department of Public Safety records; and whose phone numbers could be located. Additional eligibility criteria were visual acuity impairment, slowed visual processing speed, or both, and a Mini-Mental State Examination score of > or =23. Persons in the recruitment population who met these eligibility criteria and agreed to enroll in a study on driver safety (purpose of the main study) numbered 403.
  
  
  METHODS
  The following questionnaires were interviewer administered in person and scored per standard procedures: the NEI VFQ-25, the Center for Epidemiological Studies Depression Scale (CES-D), a general health questionnaire, and a review of demographic information. Depressed persons were defined as those with CES-D scores of > or =16. There were complete data on 397 persons.
  
  
  METHODS
  Reduced score on the NEI VFQ-25 (defined by a score of <87.5) on the total questionnaire and 12 subscales.
  
  
  RESULTS
  After adjusting for demographics, vision, mental status, and general health, depression was significantly associated with a reduced NEI VFQ-25 score for total score and the subscales of distance vision, peripheral vision, role difficulties, dependencies, and mental health. Odds ratio point estimates in these adjusted associations ranged from 2.9 to 4.6.
  
  
  CONCLUSIONS
  The results imply that older persons who are depressed may have reduced scores on the NEI VFQ-25 independent of the impact of vision problems. Depression in the elderly could be influencing their self-perception of the burden of eye disease and treatment effectiveness in clinical and epidemiologic studies.
authors.affiliation: Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama 35294-0009, USA. owsley@uab.edu
authors.forename: Cynthia
authors.initials: C
authors.lastname: Owsley
authors.forename: Gerald
authors.initials: G
authors.lastname: McGwin
mesh_terms: D000368:Aged; D001334:Automobile Driving; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005128:Eye Diseases / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009316:National Institutes of Health (U.S.) / Q000592:standards; D011788:Quality of Life; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014481:United States; D014792:Visual Acuity