title: Explaining the relationship between three eye diseases and depressive symptoms in older adults.
abstract: OBJECTIVE
  The purpose of this study is to examine whether patients with age-related eye diseases, like age-related macular degeneration (AMD), glaucoma, or Fuchs corneal dystrophy, are more likely to show signs of depression compared to a control group of older adults with good vision, and to determine whether reduced mobility mediates these relationships.
  
  
  METHODS
  We recruited 315 eligible patients (81 with AMD, 55 with Fuchs, 91 with glaucoma, and 88 controls) from the ophthalmology clinics of a Montreal hospital from September 2009 until December 2011. Depressive symptoms were assessed using the Geriatric Depression Scale Short Form (GDS-15). Life space was measured using the Life Space Assessment. Logistic regression was used to adjust for demographic, health, and social factors, and mediation was assessed using the methods of Baron and Kenny.
  
  
  RESULTS
  There were 78 people (25%) meeting the criteria for depression in the cohort. All three groups with eye disease were more likely to be depressed than the control group after adjusting for age, sex, ethnicity, education, cognitive score, limitations in activities of daily living, social support, and lens opacity (P < 0.05). Life space and limited activities due to a fear of falling appeared to mediate the relationship between eye disease and depression.
  
  
  CONCLUSIONS
  Visually limiting eye disease is associated with depression in older adults. Further research on interventions to prevent depression in patients with eye disease is warranted and should consider strategies to alleviate mobility limitation. Greater attention from families, physicians, and society to the mental health needs and mobility challenges of patients with eye disease is needed.
authors.affiliation: Centre de Recherche, Hôpital Maisonneuve-Rosemont, Montréal, Canada.
authors.forename: Mihaela L
authors.initials: ML
authors.lastname: Popescu
authors.forename: Hélène
authors.initials: H
authors.lastname: Boisjoly
authors.forename: Heidi
authors.initials: H
authors.lastname: Schmaltz
authors.forename: Marie-Jeanne
authors.initials: MJ
authors.lastname: Kergoat
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Rousseau
authors.forename: Solmaz
authors.initials: S
authors.lastname: Moghadaszadeh
authors.forename: Fawzia
authors.initials: F
authors.lastname: Djafari
authors.forename: Ellen E
authors.initials: EE
authors.lastname: Freeman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015350:Contrast Sensitivity / Q000502:physiology; D003866:Depressive Disorder / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000503:physiopathology*; D015577:Geriatric Assessment; D005901:Glaucoma / Q000503:physiopathology*; D006801:Humans; D007361:Intelligence Tests; D008268:Macular Degeneration / Q000503:physiopathology*; D008297:Male; D018434:Sickness Impact Profile; D014786:Vision Disorders / Q000503:physiopathology*; D015348:Vision, Binocular / Q000502:physiology; D014794:Visual Fields / Q000502:physiology