Older adults with cataracts are at greater risk for depression, particularly among those with lower levels of education, according to a new Chinese study published in the journal Optometry and Vision Science.
“[O]ur study sheds further light on the complex relationship between aging, vision loss, cataract, and depression and suggests that there may be a role for cataract surgery in improving mental health in the elderly,” writes Haifang Wang, M.Sc., of Soochow University, Suzhou, China, and colleagues.
Cataracts are a common problem in older adults. With this condition, the lens of the eye becomes increasingly cloudy and opaque and eventually leads to vision loss.
Cataracts are the leading cause of visual impairment worldwide and are expected to increase as demographics shift toward an older population. Depression is also common in older adults.
For the study, approximately 4,600 older adults (60 years and older) in one Chinese town completed a depression questionnaire. Participants were also given a clinical eye examination to rate the presence and severity of cataracts.
Excluding those with previous cataract surgery, nearly half (49 percent) of older adults in the study had cataracts in at least one eye. On the depression questionnaire, eight percent of subjects had depressive symptoms. Symptoms of depression were more common in women than men (11 versus five percent) and more common in older age groups.
Older adults with cataracts were more likely to have symptoms of depression, independent of socioeconomic status, lifestyle factors, and visual acuity. On adjusted analysis, the researchers found that symptoms of depression were 33 percent more likely in people with cataracts.
Importantly, the odds of depressive symptoms were similar for all participants with cataracts, whether the cataracts were found in one eye or both eyes.
The link between cataracts and depression was even stronger for subjects with no formal education — a 50 percent increase. After all other factors were taken into account, cataracts explained 14 percent of the variation in depression risk.
The study does not show the direction of the association. Vision loss might cause older adults to become isolated and withdrawn, or depression might make them less likely to seek treatment for cataracts.
“These results suggest that optometrists and vision care professionals should think beyond the direct effects of cataracts on visual impairment. We should also consider the broader impact that vision loss may have on mental health and well-being,” noted Michael Twa, O.D., Ph.D., F.A.A.O., Editor-in-Chief of Optometry and Vision Science.
“As a next step, it would be important to know if the associated depression in older adults is reversible following the restoration of vision after cataract surgery.”
Source: Optometry and Vision Science