Vision impairment and self-reported anxiety and depression in older adults in Nigeria: evidence from a cross-sectional survey in Kogi State

Abstract

Background More than 2 billion people are thought to be living with some form of vision impairment worldwide. Yet relatively little is known about the wider impacts of vision loss on individual health and well-being, particularly in low- and middle-income countries (LMICs). This study estimated the associations between all-cause vision impairment and self-reported symptoms of anxiety and depression among older adults in Kogi State, Nigeria. Methods Individual eyes were examined according to the standard Rapid Assessment of Avoidable Blindness methodology, and anxiety and depression were assessed using the Washington Group Short Set on Functioning–Enhanced. The associations were estimated using multivariable logistic regression models, adding two- and three-way interaction terms to test whether these differed for gender subgroups and with age. Results Overall, symptoms of either anxiety or depression, or both, were worse among people with severe visual impairment or blindness compared with those with no impairment (OR=2.72, 95% CI 1.86 to 3.99). Higher levels of anxiety and/or depression were observed among men with severe visual impairment and blindness compared with women, and this gender gap appeared to widen as people got older. Conclusions These findings suggest a substantial mental health burden among people with vision impairment in LMICs, particularly older men, underscoring the importance of targeted policies and programmes addressing the preventable causes of vision impairment and blindness.

Anxiety Disorder among Older Adults with Visual Impairment in Ekiti, Nigeria: Implications for the Potential Opportunity to Mitigate the Impact of the Disability and Prevent Psychological Harm

“…Demmin & Silverstein (2020) found an association between visual impairment and anxiety disorder. A study by Gascoyne et al (2022) in Kogi State, Nigeria, reported that severe visual impairment was more associated with anxiety disorder. Similarly, Assi et al (2021) found that worse visual impairment was linked to lower quality of life.…”

“…van der Aa et al (2015) discovered a prevalence of 7.5% among visually impaired older adults using the Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) criteria. A study conducted by Gascoyne et al (2022) in Nigeria reported that the prevalences of anxiety among male older adults were 12.7% and 12.4% among females. Another study, also conducted in Nigeria and employed the same instrument, found that the prevalences of anxiety among male and female participants aged 18 years and older with glaucoma and cataract were 35.5% and 21.8%, respectively (Okudo et al 2021).…”

“…Unfortunately, treatment of latestage glaucoma through medication, surgery, and combination therapies did not result in significant improvement (Pratista et al 2022). In Nigeria, the National Blindness and Visual Impairment Survey conducted in 2005-2007 reported that 4.2% of people aged >40 years were blind and 11.5% had moderate to severe visual impairment (Gascoyne et al 2022).…”

Socioeconomic position and eye health outcomes: identifying inequality in rapid population-based surveys

“…We found no patterns of inequality or significant differences between quintiles for any of our selected eye health outcomes by relative objective asset wealth. Similarly, a 2020 RAAB survey in rural Nigeria included an EquityTool questionnaire benchmarked to 2013 national DHS data 30. The proportion of participants in each quintile was not reported, but there was no pattern of inequality or significant differences in blindness, severe VI or moderate VI across wealth quintiles.…”

Prevalence and causes of blindness and visual impairment in Kogi state, Nigeria – Findings from a Rapid Assessment of Avoidable Blindness survey

“…Disability (reported elsewhere 14 ) was measured using the Washington Group Short Set (WGSS) on Functioning a tool comprising six questions regarding self-reported difficulties in six domains of functioning: seeing, hearing, climbing stairs or walking, remembering or concentrating, self-care, and communication 15 . The severity of disability was measured on a graded scale - ‘no difficulty’, ‘some difficulty’, ‘a lot of difficulty’ and ‘cannot do at all’.…”