Visual impairment and depressive symptoms in an older Australian cohort: longitudinal findings from the Blue Mountains Eye Study.
OBJECTIVE
To assess the association between visual impairment (VI) and subsequent presence of depressive symptoms among older persons.


METHODS
Of the 3654 baseline participants (aged over 49 years) of the Blue Mountains Eye Study, 2334, 1952 and 1149 were re-examined after 5, 10 and 15 years, respectively. VI was defined as best-corrected visual acuity <6/12 in either or both eyes. Presence of depressive symptoms was defined if mental health index (MHI) scores <59 or incident use of antidepressant medications. Persons with VI detected at the 5-year or 10-year follow-up visits were assessed for depressive symptoms in 5 years. Persons with VI detected at baseline or the 5-year follow-up were assessed for depressive symptoms over 10 years. Controls were persons without VI over the corresponding period. Discrete logistic regression models with time-dependent study and outcome variables were used, adjusting for potential confounders.


RESULTS
Of 1568 participants who had the MHI assessed at two consecutive visits, 226 had bilateral or unilateral VI detected 5 years earlier and 120 had VI detected over 10 years earlier. Depressive symptoms were reported in 27% and 31.6% of cases with VI detected 5 and over 10 years earlier, respectively, compared with 10.8%-11.5% of controls. There was a significantly greater odds of presenting depressive symptoms among VI cases detected 5 years earlier (OR, 3.06, 95% CI 1.72 to 5.44), but this was non-significant for cases detected over 10 years earlier (OR 1.29, 95% CI 0.84 to 1.98).


CONCLUSIONS
VI was associated with subsequently presenting depressive symptoms over 5 years among older persons.
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
Thomas
T
Hong
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
Paul
P
Mitchell
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
George
G
Burlutsky
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
Bamini
B
Gopinath
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
Gerald
G
Liew
Department of Ophthalmology, Westmead Millennium Institute, Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia.
Jie Jin
JJ
Wang
D000368:Aged; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007361:Intelligence Tests; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities / Q000706:statistics & numerical data*
Epidemiology; Vision