By Will Boggs MD
Older adults with impaired vision are more likely to have symptoms of anxiety and depression, and older adults with symptoms of anxiety or depression are more likely to develop vision impairment, according to findings from the U.S. National Health and Aging Trends Study.
"Older adults are at a high risk for vision problems compared to other segments of the population," the study's senior author Dr. Joshua R. Ehrlich from the University of Michigan, Ann Arbor, told Reuters Health. "Vision impairment, particularly in later life, has many consequences beyond not seeing clearly, including an increased risk of mood disorders."
Using data from more than 7,500 older men and women, Ehrlich's team found that far more individuals with impaired vision reported symptoms of depression than those without vision problems: 31 percent versus 13 percent. The same was true for anxiety symptoms, reported by 27 percent of those with vision impairment and 11 percent of those without it, according to the results in JAMA Ophthalmology, May 16.
Overall, more than 40 percent of participants with impaired vision had either depression or anxiety symptoms, compared with just under 19 percent of those without impaired vision.
People with impaired vision were also 33 percent more likely than those without it to report new symptoms of depression over time, but the same didn't hold true for anxiety.
At the same time, individuals with symptoms of depression were 37 percent more likely to develop impaired vision in the future than people without depression, and those with anxiety symptoms were 55 percent more likely than those without anxiety.
"Vision loss is associated with many adverse health consequences beyond not seeing clearly," Ehrlich said in an email. "Poor vision not only increases the risk of mood disorders, but also cognitive decline, falls, loss of independence, and even mortality," he noted.
"However, poor vision is not an inevitable part of aging, and an estimated 80 percent of vision loss is preventable or treatable. Accordingly, vision care is a vital component of promoting overall health, well-being, and optimal aging," he said.
"In our clinical practice, we observe exactly this, that advanced age associated with low visual acuity generally leads to mood and anxiety disorders," said Dr. Marina Ribeiro from Universidade Federal de Alagoas in Maceio, Brazil, who wasn't involved in the study.
"This is of clinical relevance, because it works as a warning to family members, who should seek psychological and psychiatric attention for patients with low visual acuity if they observe any change in mood," she told Reuters Health by email.
"No one should underestimate the mood swings in patients with low visual acuity," Ribeiro added.
"What is new and most interesting about this study to my opinion is its bidirectional focus on the longitudinal association between visual impairment and mental health," said Dr. Hilde van der Aa from Amsterdam University Medical Center in The Netherlands, who also wasn't involved in the study.
"Both mental healthcare professionals and eye care professionals should be aware of the bidirectional association between visual impairment and mental health, to be able to offer tailored support and timely referrals from which patients could directly benefit," she said by email.
SOURCE: https://bit.ly/2M1Sk1l and https://bit.ly/2HPrV1w JAMA Ophthalmol 2019.
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