Depression and mortality in the visually‐impaired, community‐dwelling, elderly population of Quebec

Abstract

ABSTRACT.Purpose: To assess the effect of visual impairment (VI) on the risk of depression or death in the community-dwelling elderly population. Methods: A population-based, retrospective fixed cohort study was conducted in the community-dwelling elderly (age ‡ 65 years) outpatient population of Quebec. The cohort was assembled through the Quebec medical services database and consisted of the 5063 patients aged ‡ 65 years who received a diagnosis of VI during the years 2000-2004. The reference cohort consisted of 16 932 elderly subjects who were randomly selected among members of the public drug programme. The outcome variables were depression and death. The main independent variable was VI and covariates included age, gender, chronic disease score, fracture and diabetes. Results: Controlling for covariates, VI was associated with an increased risk of depression although the effect was not modified by severity (hazard ratio [HR] = 1.35, 95% confidence interval [CI] 1.10-1.66 for severe VI; HR = 1.35, 95% CI 1.09-1.69 for moderate VI). Visual impairment was associated with an increased risk of mortality; patients with moderate vision loss had a higher risk of death (HR = 1.70, 95% CI 1.55-1.87) than those with severe vision loss (HR = 1.34, 95% CI 1.21-1.48). Conclusions: Given the ageing of the population, VI in elderly subjects is becoming a public health concern. These findings enhance the need to detect and treat VI in order to improve the quality of life and to prevent premature mortality in the elderly population.

A prospective study of the bi-directional association between vision loss and depression in the elderly

“…The absence of association for moderate to severe impairment is probably due to a lack of power, only 2% of subjects being in this category at baseline. In a population-based longitudinal study, Tournier et al (Tournier et al, 2008) used a medical services data-base with International Classification of Diseases (ICD-9) algorithms, showing that over a 5-year period the risk of depression was higher in the group of subjects with objective visual impairment compared with the control group, and that the effect did not depend on visual impairment severity. However, in this study, the models were poorly adjusted without including socio-economic and behavioral factors or comorbidity, and only adjusting for chronic diseases as a single score.…”

“…Only three longitudinal, elderly population-based studies have been undertaken which have confirmed the association between visual impairment (Tournier et al, 2008) or visual function loss (Brown and Barrett, 2011;Chou, 2008) and subsequent high levels of depressive symptomatology. However these studies did not include the full range of common risk factors for both visual impairment and depressive symptoms (notably diabetes, hypertension, cardiovascular diseases, cognitive impairment, smoking, obesity) which may confound this association, and two of these studies only used self-declared non-specific visual function (Brown and Barrett, 2011;Chou, 2008).…”

Association between visual impairment and depression in the elderly: a systematic review

“…Each item is scored on a scale from 0 (less than 2 days duration) to 3 (5-7 days, both days inclusive), and a score of 16 or more indicates major depression. One of the studies (28) used depression diagnosis based on the International Diseases Code (ICD-10). Because of this heterogeneity, meta-analysis was not possible with this variable.…”

Impacto do déficit visual na qualidade de vida em idosos usuários do sistema único de saúde vivendo no sertão de Pernambuco

“…Indivíduos sem déficit visual possuíam esco re de saúde mental maior. Tal achado vem sugerir que o déficit visual po de estar associado com um maior risco de depressão (9) . Os idosos com pior visão possuem maior mortalidade (9) .…”

“…Tal achado vem sugerir que o déficit visual po de estar associado com um maior risco de depressão (9) . Os idosos com pior visão possuem maior mortalidade (9) . Todos esses achados ra tificam a importância de se intervir em políticas públicas para di minuição do impacto do déficit visual sobre a vida dos indivíduos, pois além de trazer benefícios na qualidade de vida desta população, poderia haver menor dependência aos serviços previdenciários e diminuir a utilização dos serviços de saúde.…”