The impact of cataract surgery on depression among older adults

Department of Epidemiology & International Health, School of Public Health, University of Alabama at Birmingham, Birmingham, AL 35294-0009, USA.
Ophthalmic Epidemiology (Impact Factor: 1.15). 01/2004; 10(5):303-13. DOI: 10.1076/opep.10.5.303.17323
Source: PubMed


Aged-related cataract is the leading cause of vision impairment in the elderly. Elderly individuals with cataract not only suffer from the difficulties in daily activities, but also are more prone to depression.
To examine the impact of cataract surgery on depression among older adults.
Longitudinal follow-up study.
Outpatient ophthalmology and optometry clinics in Birmingham, Alabama.
Potential subjects were identified through consecutive chart review of patients seen in 10 ophthalmology and 2 optometry clinics. Three groups of individuals were identified: cataract patients who underwent surgery, cataract patients who did not undergo surgery, and patients without cataract.
Depressive symptoms as measured by the Center for Epidemiological Studies-Depression Scale (CES-D).
There was no significant difference between the baseline and follow-up CES-D scores within each group. The unadjusted CES-D score changes did not differ significantly among the three groups. Adjustment for visual acuity and contrast sensitivity in the better and worse eyes, co-morbid conditions, age, gender, and education did not alter this pattern of results.
Cataract surgery does not appear to have an effect on reducing depressive symptoms in elderly people.

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    • "Livingston et al. (2001) found that the prevalence of psychotic illness in people aged 65 and over was at least 5.6%, and persecutory symptoms and perceptual disturbance were 2.8 times more likely to be present if the person was visually impaired. Surprisingly, McGwin et al. (2003) found that cataract surgery did not seem to have a significant effect on reducing depressive symptoms in older people. There is a need for more research on the effect of visual interventions on depression in older people with correctable VI. "
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    ABSTRACT: This review seeks to determine the prevalence of correctable visual impairment (VI) in older people in the UK, to discover what proportion of these cases are undetected, to suggest reasons for the poor detection and to make recommendations for improving the detection. To establish the context of these issues, the review will also touch on the general prevalence and causes of VI in older people in developed countries and on the impact of VI in older people. Typically, studies suggest that VI affects about 10% of people aged 65-75, and 20% of those aged 75 or older. There is a strong relationship between impaired vision in older people and both reduced quality of life and increased risk of accidents, particularly falls. The literature suggests that those with low vision are about two times more likely to have falls than fully sighted people, and the annual UK cost of treating falls directly attributable to VI is pound 128 million. The literature on the prevalence of undetected reduced vision in older people reveals that between 20 and 50% of older people have undetected reduced vision. The majority of these people have correctable visual problems (refractive errors or cataract). It is particularly startling that, in 'developed countries', between 7 and 34% of older people have VI that could simply be cured by appropriate spectacles. The reasons why so many cases of treatable VI remain untreated are discussed, and suggestions are made for improving the detection of these cases. We conclude that there should be better publicity encouraging older people to attend for regular optometric eye examinations. A complementary approach is annual visual screening of the elderly, possibly as part of GPs annual health check on people aged 75 years and older. Recommendations are made for evaluating new approaches to screening and for improving the management of cases detected by screening.
    Ophthalmic and Physiological Optics 06/2004; 24(3):161-80. DOI:10.1111/j.1475-1313.2004.00197.x · 2.18 Impact Factor
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    • "sonucu (görme azalmas›, körlük) birtak›m psikiyatrik tablolar›n oluflmas›n› sa¤layabilir. Yap›lan bâz› çal›flmalar katarakt, glokom, maküler dejenerasyon, Behçet Hastal›¤› gibi görme kayb›na neden olan kronik göz hastal›klar›na ba¤l› geliflen görme bozukluklar› ile depresyon, anksiyete ve yaflam kaliteleri aras›ndaki iliflkiler ele al›nm›flt›r (Mc Gwin ve ark. 2003, Brody ve ark. 2001, Wilson ve ark. 2002, Erb ve ark. 1993, Karlidag ve ark. 2003)."
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    ABSTRACT: ÖZET Amaç: Bu araflt›rmada glokom hastalar›n›n psikiyatrik aç›dan deerlendirilerek depresyon, anksi- yete ve aleksitimi özelliklerinin araflt›rmas› amaçlanm›flt›r. Yöntem: Çal›flmaya 73 glokom hastas› ve k›rma kusuru ile göz kliniine baflvurmufl, baflka bir göz hastal›¤› ve psikiyatrik hastal›¤› bulunmayan, sosyodemografik aç›dan hasta grubu ile benzer özel- likteki 40 kontrol grubu dâhil edildi. Göz kliniinde muayenelerini takiben, psikiyatri kliniinde ya- r› yap›land›r›lm›fl sosyodemografik bilgi formu ve DSM-IV eksen I bozukluklar› için yap›land›r›lm›fl klinik görüflme (SCID-I) ile deerlendirildi. Hasta ve kontrol gruplar›na Standardize Mini Mental Durum Deerlendirmesi (MMDD), Belirti Tarama Listesi (SCL-90-R), Hamilton Depresyon Derece- lendirme Ölçei-17 itemli (HAM-D), Hamilton Anksiyete Derecelendirme Ölçei (HAM-A), Yirmi Maddelik Toronto Aleksitimi Ölçei (TAÖ-20) uyguland›. Bulgular: Glokomlu hastalarda en s›k rastlanan tan›n›n depresif bozukluklar (%24.7) olduu gö- rülmektedir. Hasta grubunda HAM-D ortalama puanlar› kontrol grubundan anlaml› olarak daha yüksekti ((p0.05). Glokomlu hastalarda SCL-90-R alt ölçeklerinden somatizasyon, kifliler aras› duyarl›l›k, depresyon ortalama puanlar› kont- rol grubuna göre anlaml› flekilde daha yüksekti (p0.05). Tart›flma ve Sonuç: Glokomlu hastalarda depresyonun anlaml› derecede yüksek ç›kmas›n›n, kro- nik hastal›klar ile depresyon aras›ndaki iliflkiyi göstermesi aç›s›ndan önemli olduu düflüncesinde- yiz. Glokomlu hastalar›n deerlendirilmesi ve tedavi plân›nda psikiyatrik aç›dan da ele al›nmas›, onlara optimal tedavi ve bak›m salamas› aç›s›ndan faydal› olaca¤› görüflündeyiz. Anahtar Kelimeler: glokom, depresyon, anksiyete, aleksitimi ABSTRACT Psychiatric evaluation of patients with glaucoma Objective: To evaluate glaucoma patients mentally and to determine the depression, anxiety, and alexithymia levels in this group of patients. Method: The sample was comprised of 73 outpatients with glaucoma and 40 controls with simi- lar sociodemographic features, and who applied to the Ophthalmology Clinics with refractive er- rors only. Following their examination by an ophthalmologist, each patient was then evaluated by a psychiatrist using the Structured Clinical Interview for DSM-IV (SCID-I), Turkish version. All pati- ents and controls were applied the Mini Mental State Examination (MMSE), the Symptom Check- list-90-Revised (SCL-90-R), the 17-item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), the 20-item Toronto Alexithymia Scale (TAS-20). Findings: Depressive disorders were the most common psychiatric diagnosis (24,7%). The mean HDRS scores of the glaucoma patients were significantly higher than the controls (p0,05). In glaucoma patients, the mean SCL-90-R scores of somatization, interpersonal sensitivity, and depression were significantly higher than the controls (p0,05). Discussion and Conclusion: We believe the significantly high depression levels in glaucoma pa- tients are important to show the relationship between depression and chronic diseases. Evaluating glaucoma patients mentally will help to provide optimal treatment and care in this group of pati-
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    ABSTRACT: The prevalence of major depression (MD) in persons with nonpsychiatric medical conditions is an indicator of clinical need in those groups, an indicator of the feasibility of screening and case-finding efforts, and a source of etiologic hypotheses. This analysis explores the prevalence of MD in the general population in relation to various long-term medical conditions. We used a dataset from a large-scale Canadian national health survey, the Canadian Community Health Survey (CCHS). The sample consisted of 115 071 subjects aged 18 years and over, randomly sampled from the Canadian population. The survey interview recorded self-reported diagnoses of various long-term medical conditions and employed a brief predictive interview for MD, the Composite International Diagnostic Interview Short Form for Major Depression. Logistic regression was used to adjust estimates of association for age and sex. The conditions most strongly associated with MD were chronic fatigue syndrome (adjusted odds ratio [AOR] 7.2) and fibromyalgia (AOR 3.4). The conditions least strongly associated were hypertension (AOR 1.2), diabetes, heart disease, and thyroid disease (AOR 1.4 in each case). We found associations with various gastrointestinal, neurologic, and respiratory conditions. A diverse set of long-term medical conditions are associated with MD, although previous studies might have lacked power to detect some of these associations. The strength of association in prevalence data, however, varies across specific conditions.
    Canadian journal of psychiatry. Revue canadienne de psychiatrie 04/2005; 50(4):195-202. · 2.55 Impact Factor
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