Major Depressive and Anxiety Disorders in Visually Impaired Older Adults

Vision loss is one of the leading causes of disability in older adults, and is associated with reduced quality of life and increased depressive and anxiety symptoms.

16 In turn, depression and anxiety may cause a further decline in quality of life, may aggravate disability caused by the visual impairment, and may increase vulnerability for health decline.69 By the year 2020 depression is expected to be the major cause of disease burden for older populations.10,11 The prevalence of visual impairment in developed countries is growing due to demographic ageing.1 Therefore, the burden on eye care and mental health care for people with a visual impairment is expected to increase.
: We assessed the prevalence of subthreshold depression and anxiety, and major depressive, dysthymic, and anxiety disorders (panic disorder, agoraphobia, social phobia, and general anxiety disorder) in visually impaired older adults and compared these estimates with those of normally sighted peers.

Methods.: Cross-sectional data were analyzed based on telephone interviews with visually impaired older adults aged ≥ 60 years (n = 615) with a visual acuity of ≥ 0.30 logMAR (20/40 Snellen) in the best eye from outpatient low vision rehabilitation centers, and face-to-face interviews with community-dwelling normally sighted peers (n = 1232). To determine prevalence rates, the normally sighted population was weighted on sex and age to fit the visually impaired population. Logistic regression analyses were used to compare the populations and to correct for confounders.

Results.: The prevalence of major depressive disorder (5.4%) and anxiety disorders (7.5%), as well as the prevalence of subthreshold depression (32.2%) and subthreshold anxiety (15.6%), were significantly higher in visually impaired older adults compared to their normally sighted peers (P < 0.05). Agoraphobia and social phobia were the most prevalent anxiety disorders in visually impaired older adults.

Conclusions.: This study shows that depression and anxiety are major public health problems in visually impaired older adults. Research on psychotherapeutic and psychopharmacologic interventions to improve depression and anxiety in this population is warranted. ( number, NTR3296.)

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