The impact of cataract surgery on depression among older adults.
ABSTRACT 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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ABSTRACT: Little information exists on the impact of cataract surgery on falls and other injuries in Vietnam. The aim of this study was to determine the impact of first and both eye cataract surgery on the number of falls and other injuries among bilateral cataract patients in Ho Chi Minh City, Vietnam. A longitudinal cohort study was conducted involving 413 bilateral cataract patients aged 50+ years. Participants were assessed at three time points: 1 week before, 1-3 months after, and 1 year after first-eye cataract surgery. Visual measures (visual acuity, contrast sensitivity and stereopsis) were taken, and self-reported falls and injury data were collected. A multilevel longitudinal Poisson regression model was used to investigate change in the number of falls after surgery. The risk of falls decreased by 78% (incidence-rate ratio [IRR] 0.22, 95% confidence interval [CI] 0.06-0.77; P=0.018) in the year after cataract surgery for participants who had first-eye surgery only and 83% (IRR 0.17, 95% CI 0.04-0.69; P=0.012) for participants who had the second eye operated on compared to before surgery. The risk of falls was three times higher for females than males (IRR 3.13, 95% CI 1.53-6.40; P=0.002). Improved binocular contrast sensitivity was also associated with a decrease in falls (IRR 0.40, 95% CI 0.17-0.97; P=0.042). The prevalence of other injuries also decreased after cataract surgery. Cataract surgery reduced the number of falls and other injuries in Vietnam. Contrast sensitivity may be important for ophthalmologists to consider when prioritizing patients for surgery and assessing their fall risk.Clinical Interventions in Aging 01/2014; 9:743-51. DOI:10.2147/CIA.S61224 · 1.82 Impact Factor
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ABSTRACT: This study examined the prevalence of co-morbid age-related eye disease and symptoms of depression and anxiety in late life, and the relative roles of visual function and disease in explaining symptoms of depression and anxiety. A community-based sample of 662 individuals aged over 70 years was recruited through the electoral roll. Vision was measured using a battery of tests including high and low contrast visual acuity, contrast sensitivity, motion sensitivity, stereoacuity, Useful Field of View, and visual fields. Depression and anxiety symptoms were measured using the Goldberg scales. The prevalence of self-reported eye disease [cataract, glaucoma, or age-related macular degeneration (AMD)] in the sample was 43.4%, with 7.7% reporting more than one form of ocular pathology. Of those with no eye disease, 3.7% had clinically significant depressive symptoms. This rate was 6.7% among cataract patients, 4.3% among those with glaucoma, and 10.5% for AMD. Generalized linear models adjusting for demographics, general health, treatment, and disability examined self-reported eye disease and visual function as correlates of depression and anxiety. Depressive symptoms were associated with cataract only, AMD, comorbid eye diseases and reduced low contrast visual acuity. Anxiety was significantly associated with self-reported cataract, and reduced low contrast visual acuity, motion sensitivity and contrast sensitivity. We found no evidence for elevated rates of depressive or anxiety symptoms associated with self-reported glaucoma. The results support previous findings of high rates of depression and anxiety in cataract and AMD, and in addition show that mood and anxiety are associated with objective measures of visual function independently of self-reported eye disease. The findings have implications for the assessment and treatment of mental health in the context of late-life visual impairment.Frontiers in Aging Neuroscience 01/2013; 5:56. DOI:10.3389/fnagi.2013.00056 · 2.84 Impact Factor
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ABSTRACT: Cataract affects not only vision, but also performance of everyday tasks, participation in social activities, quality of life and possibly depression. Depression is a major health issue for older adults. It is estimated that 6%-20% of community-dwelling older Australians experience depression. The aim of this study was to investigate changes in vision-related quality of life and depressive symptoms after first eye cataract surgery and to determine which visual measures affect the change in these outcomes. In 2009 and 2010, 99 participants with bilateral cataract were recruited. Visual measures including visual acuity, contrast sensitivity and stereopsis were assessed 1 week before and 12 weeks after first eye cataract surgery. Vision-related quality of life was measured using the 25-item National Eye Institute Visual Function Questionnaire. Depressive symptoms were assessed by the 20-item Center for Epidemiological Studies Depression Scale. Separate regression analyses were undertaken to determine the association between visual measures and changes in vision-related quality of life and depressive symptoms after first eye cataract surgery. Overall, vision-related quality of life improved after first eye cataract surgery. There was a small, non-clinically significant improvement in depressive symptoms after surgery. Improvement in vision-related quality of life after first eye cataract surgery was associated with improved contrast sensitivity in the operated eye (P < 0.001), whereas improvement in depressive symptoms after surgery was associated with improved stereopsis (P = 0.032). Contrast sensitivity and stereopsis, but not visual acuity, were significant factors affecting improvement in vision-related quality of life or depressive symptoms after first eye cataract surgery.Psychogeriatrics 10/2013; 13(4). DOI:10.1111/psyg.12028 · 1.22 Impact Factor