title: Depressive symptoms in older adults awaiting cataract surgery.
abstract: BACKGROUND
  To assess the prevalence and predictors of depressive symptoms in a cohort of older adults awaiting cataract surgery and establish threshold vision at which depressive symptoms may emerge.
  
  
  METHODS
  Analysis of cross-sectional baseline data from a longitudinal cohort study of patients aged ≥65 years on Australian public hospital cataract surgery waiting lists.
  
  
  METHODS
  We included 329 participants enrolled October 2013-August 2015.
  
  
  METHODS
  Participants completed assessment of depressive symptoms, visual disability, quality of life, social participation and exercise frequency at least one month prior to cataract surgery. High and low contrast habitual vision was examined and systemic comorbidities noted.
  
  
  METHODS
  Depressive symptoms prior to first eye cataract surgery.
  
  
  RESULTS
  The prevalence of depressive symptoms was 28.6% (94/329). Univariate analysis identified that participants with poorer high contrast vision, reduced quality of life, greater patient-reported visual disability, higher comorbidity score and who were taking more medications were more likely to exhibit signs of depression. Greater patient-reported visual disability (P = 0.02), reduced quality of life (P = 0.003) and a higher comorbidity score (P = 0.02) remained significantly associated with depressive symptoms in the multivariable model. Depressive symptoms emerged at a visual acuity of 6/12.
  
  
  CONCLUSIONS
  These findings demonstrate a high prevalence of depressive symptoms in older persons with cataract, emerging at modest levels of vision loss. Efficient referral processes, timely surgical management, and improved screening and coordinated treatment of depressive symptoms during the surgical wait may minimize the negative psychological effects of cataract in this already vulnerable population.
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Anna
authors.identifier: http://orcid.org/0000-0002-8127-9351
authors.initials: A
authors.lastname: Palagyi
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Kris
authors.initials: K
authors.lastname: Rogers
authors.affiliation: Curtin-Monash Accident Research Centre (C-MARC), Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.|Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Meuleners
authors.affiliation: Save Sight Institute, Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Peter
authors.initials: P
authors.lastname: McCluskey
authors.affiliation: Save Sight Institute, Sydney Medical School, University of Sydney, New South Wales, Australia.|Westmead Institute for Medical Research, Sydney, New South Wales, Australia.|Department of Ophthalmology, Westmead Hospital, Sydney, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: White
authors.affiliation: Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Jonathon Q
authors.initials: JQ
authors.lastname: Ng
authors.affiliation: Eye and Vision Epidemiology Research Group, School of Population Health, University of Western Australia, Perth, Western Australia, Australia.
authors.forename: Nigel
authors.initials: N
authors.lastname: Morlet
authors.affiliation: The George Institute for Global Health, Sydney Medical School, University of Sydney, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Keay
mesh_terms: D000368:Aged; D002386:Cataract / Q000453:epidemiology* / Q000503:physiopathology; D002387:Cataract Extraction; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D011788:Quality of Life; D018434:Sickness Impact Profile; D014786:Vision Disorders / Q000503:physiopathology; D014792:Visual Acuity / Q000502:physiology; D014850:Waiting Lists
keywords: cataract; depressive symptoms; surgery wait time; visual disability