A recent study published in Cornea evaluated both demographic factors and psychiatric comorbidities and their associations with dry eye disease (DED) in the general American population.
Give me some background first.
While DED has been extensively studied, possible impact from psychiatric comorbidity and certain demographics within populations have been less explored.
Researchers set out to examine these relationships within this study.
Now, talk about the study.
This study included data from a 2011 nationwide sample of Medicare beneficiaries aged 65+.
The sample amounted to a total of 1,321,000 patients. Multivariable regression models were then used on this data to explore possible relationships.
What were the outcome measures?
Primary psychiatric outcome measures were both anxiety and depression. Demographic information that was measured included:
- Age
- Sex
- Race/ethnicity
- Residential area
- Climate region
- Income
Findings?
Both depression and anxiety were associated with greater likelihood to have DED(1.95 odds ratio [OR] and 2.22 OR, respectively).
In addition, when having both anxiety and depression, the DED OR rose to 2.38.
Expert opinion?
The study authors suggested that “mental health status may become more closely linked to dry eye severity with increasing disease duration.”
They continued: “The ocular discomfort experienced by patients with these comorbidities may be related to somatization instead of ocular surface desiccation.
Thus, they concluded that depression and anxiety are closely associated dry eye symptoms, but not clinical signs of dry eye.
Now go into demographics.
In terms of age, patients aged 75+ were more likely to have DED than those aged 65-74 years old. Regionally, the Upper Midwest had the lowest DED OR, while the West had the highest.
In addition, when compared with White patients, Asian (1.85 OR) and Native American patients (1.51 OR) were more likely to have DED.
Further, Black patients (0.83 OR) were less likely to have DED when compared to White patients.
However, the authors suggested that these findings may be in part due to underdiagnosis in Black patients.
Go on…
Per the study authors: “The literature has shown that minority patients in the United States (including Asian, Black and Hispanic) present with worse baseline dry eye parameters, including increased conjunctival staining, corneal staining and tear osmolarity compared with white patients.”
Take home.
This study identified notions about racial differences in the prevalence of dry eye, in addition to finding DED to be twice as common among those with anxiety and depression.
The authors concluded: “Further research is needed to comprehend the underlying mechanisms, implications, and to address disparities in the diagnosis and management of dry eye.”