title: Role of vision loss, functional limitations and the supporting network in depression in a general population.
abstract: OBJECTIVE
  Although the prevalence of depression in visually impaired older persons is high, the association between vision loss and depression seems to be influenced by factors other than visual impairment. In this study, the role of vision loss, functional limitations and social network characteristics in relation to depressive symptoms was investigated.
  
  
  METHODS
  Cross-sectional data (N = 1237) from the Longitudinal Aging Study Amsterdam were used to investigate the prevalence of depression (Center of Epidemiological Studies-Depression scale) within subgroups with increasing vision loss. In linear regression models, functional limitations and social network characteristics were examined as possible mediators in the association between vision loss and depression. Having a partner was considered to be a potential moderator.
  
  
  RESULTS
  Although a significant linear trend was found in the presence of depressive symptoms with 14% in normally sighted, 23% in mild and 37% in severe vision loss (χ(2)(1) = 14.9; p < 0.001), vision loss was not an independent determinant of depression. Mediators were functional limitations (p < 0.001) and social network size (p = 0.009). No interaction with partner status was found.
  
  
  CONCLUSIONS
  In the presence of depression, a trend was found with increasing severity of vision loss, indicating the need for more attention in (mental) health care and low-vision rehabilitation. In the general older population, vision loss was not an independent determinant of depression but was mediated by functional limitations and social network size. Rather than receiving actual social support, the idea of having a social network to rely on when needed seemed to be associated with lower levels of depression.
authors.affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.|EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Ruth M A
authors.initials: RM
authors.lastname: van Nispen
authors.affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.|EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Hilde L
authors.initials: HL
authors.lastname: Vreeken
authors.affiliation: EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.|GGZinGeest/Department of Psychiatry, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Hannie C
authors.initials: HC
authors.lastname: Comijs
authors.affiliation: EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.|Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands.
authors.forename: Dorly J H
authors.initials: DJ
authors.lastname: Deeg
authors.affiliation: Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.|EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.|Department of Ophthalmology, Elkerliek Hospital, Helmond, the Netherlands.
authors.forename: Ger H M B
authors.initials: GH
authors.lastname: van Rens
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001766:Blindness / Q000453:epidemiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life; D012944:Social Support; D011795:Surveys and Questionnaires; D015354:Vision, Low / Q000453:epidemiology / Q000503:physiopathology*; D014792:Visual Acuity / Q000502:physiology; D019987:Persons with Visual Disabilities
keywords: depression; functional limitations; general population; older adults; partner; social network; social support; visual impairment