Depression in older people: visual impairment and subjective ratings of health.
OBJECTIVE
The aim of this study was to establish the prevalence of depression in a sample of older adults with impaired vision and investigate associations between physical and visual disability and depression.


METHODS
We analyzed cross-sectional baseline data from 391 participants aged >or=75 years with visual acuity of 6/24 (20/80) or less, recruited for a randomized controlled trial of interventions to prevent falls (the VIP trial). Measures included the geriatric depression scale (GDS-15), the state-trait anxiety index, activities of daily living (Nottingham extended ADL scale), physical activity (human activity profile), an index of visual functioning (VF-14), health-related quality of life (SF-36), objective measures of physical ability, and a measure of visual acuity. Regression models were developed to investigate the association between depression scores and physical, psychological, and visual disability.


RESULTS
About 29.4% (115 of 391) of participants were identified as potentially depressed (GDS-15 score >4). Physical function, physical activity, physical ability, visual function, anxiety, and self-reported physical and mental health were significantly worse for those with depressive symptomatology. Physical, visual, and psychological factors collectively explained 41% of the variance in the depression score in a linear regression model (R=0.421, adjusted R=0.410, F (7,382)=39.680, p<0.001). Depression was not related to age, gender, living situation, ethnicity, or number of prescription or antidepressant medications taken.


CONCLUSIONS
Depression was common in this population of older adults with severe visual impairment. Impaired visual and physical functions were associated with symptoms of depression. The effect of visual disability was independent of the effect of physical disability. The strength of this relationship, and the results of the regression analyses, indicate that a person who is visually or physically disabled is more likely to suffer from depression.
Department of General Practice and Primary Health Care, School of Population Health, The University of Auckland, Auckland, New Zealand. k.hayman@auckland.ac.nz
Karen J
KJ
Hayman
Ngaire M
NM
Kerse
Steven J
SJ
La Grow
Trecia
T
Wouldes
M Clare
MC
Robertson
A John
AJ
Campbell
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D016014:Linear Models; D008297:Male; D008603:Mental Health; D009043:Motor Activity; D015995:Prevalence; D012647:Self-Assessment; D012720:Severity of Illness Index; D014786:Vision Disorders / Q000503:physiopathology / Q000523:psychology*; D014792:Visual Acuity; D019987:Persons with Visual Disabilities