title: Cataract and Depressive Symptoms among Older Chinese Adults.
abstract: We aimed to assess the association of age-related cataract, a common eye condition in older people, with the presence of depressive symptoms in a community-based cohort of Chinese adults after controlling for a wide range of confounders.
  
  
  
  A community-based survey of 4611 Chinese adults aged 60 years or older was conducted. Depressive symptoms were measured using the 9-item Patient Health Questionnaire (PHQ-9) depression scale in 4597 study participants whereas age-related cataracts were graded clinically using the Lens Opacities Classification System (LOCS) III scheme. The presence of depressive symptoms was defined as a PHQ-9 score from 5 to 27. Binary logistic regression models were fitted to calculate the odds ratios and 95% confidence intervals for the association between the age-related cataract and depressive symptoms.
  
  
  
  After adjusting for age, gender, educational level, monthly income, living alone, smoking, alcohol intake, tea consumption, sleeping hours per day, and presenting visual acuity, adults with cataract had higher odds of having depressive symptoms compared with those without (odds ratio = 1.33; 95% confidence interval 1.08, 1.70). There were no significant differences in the risk of depressive symptoms between those with bilateral and unilateral cataract. Adults with nuclear cataract had the greatest odds of having depressive symptoms among all cataract subtypes. Cataract patients with less education had greater odds of having depressive symptoms compared to those with higher levels of education.
  
  
  
  Age-related cataract was related to the presence of depressive symptoms among older adults, particularly in poorly educated ones. This observed association was independent of poor vision and other potential confounders. It may be recommended that efforts and resources be channeled towards the surgical treatment programs of cataract in depressive adults.
authors.affiliation: *MSc †PhD ‡MD, PhD The Nursing Department, the First Affiliated Hospital of Soochow University, Suzhou, China (HW); Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Medical College of Soochow University, Suzhou, China (H-PS, YX, C-WP); and Saw Swee Hock School of Public Health, National University of Singapore, Singapore (PW).
authors.forename: Haifang
authors.initials: H
authors.lastname: Wang
authors.forename: Hong-Peng
authors.initials: HP
authors.lastname: Sun
authors.forename: Pei
authors.initials: P
authors.lastname: Wang
authors.forename: Yong
authors.initials: Y
authors.lastname: Xu
authors.forename: Chen-Wei
authors.initials: CW
authors.lastname: Pan
mesh_terms: D000367:Age Factors; D000368:Aged; D002386:Cataract / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D002681:China / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014792:Visual Acuity