In a cross-sectional survey presented during the 2024 annual Association for Research in Vision and Ophthalmology (ARVO) meeting earlier this month, researchers investigated the prevalence of mental health (MH) conditions and associations in individuals with macular disease.
Give me some background first.
Age-related macular degeneration (AMD) is an eye disease that can blur the central vision—and more importantly, it’s the leading cause of vision loss in older adults.
Symptoms of late AMD may include:
- Vision with straight lines appearing wavy or crooked
- Blurry area near the center of the vision that may grow larger over time
- Blank spots in vision
- Colors appearing less bright
- Difficulty seeing in low-lighting
Now, talk about the study.
Researchers recruited survey participants with Macular Disease Foundation Australia memberships and through social media advertisements.
The survey incorporated standard MH scales such as:
- Geriatric Depression Scale (GDS-15)
- Generalized Anxiety Disorder scale (GAD-7)
- University of California, Los Angeles (UCLA)-Loneliness scale (UCLA-LS)
- Lubben Social Network Scale–6 (LSNS-6)
Go on …
The survey also included associations between:
- Depressive symptoms (GDS-15>5)
- Anxiety (GAD-7>4)
- Predictor variables of socio-demographic factors
- Self-reported vision
- Diagnosis of neovascular (wet) AMD
- Systemic and ocular co-morbidities
- Social isolation (LSNS-6<12)
- Loneliness (UCLA-LS>5)
- Concerns about falling
- Worry about scams
- Sleep quality
Note: The above factors were explored in multivariable logistic regression analyses.
Who was included in the study?
A total of 1,969 participants living in Australia completed the survey, with a majority being female (68%) and aged 75+ (75%).
Findings?
The researchers found that:
- AMD was the most common eye condition (67%)
- 26% reported neovascular AMD in at least one eye
- 16% had depressive symptoms
- 21% had anxiety symptoms
- 21% were lonely
- 22% socially isolated
When it came to MH support: Of patients who screened positive for depression and moderate/severe anxiety, 56% and 50%, respectively, were not receiving MH support.
What were the findings regarding depression?
Increased odds of depressive symptoms were associated with:
- Fair/worse self-rated vision
- Multivariable-adjusted OR:4.19 (95% CI:2.28-7.70)
- Loneliness
- 3.42 (2.03-5.76)
- Social isolation
- 3.44 (2.0-5.91)
- Concerns about falling
- 2.92 (1.57-3.34)
- Poor sleep quality
- 2.42 (1.45-4.04)
- Anxiety
- 8.48 (4.97-14.48)
And the findings for anxiety?
Increased odds of anxiety were associated with:
- Aged 75+ years
- Multivariable-adjusted OR: 2.62 (95% CI:1.68-4.09)
- Loneliness
- 3.76 (2.33-6.07)
- Concerns about falling
- 1.59 (1.17-2.15)
- Poor sleep quality
- 2.28 (1.48-3.50)
- Depression
- 7.39 (4.36-12.54)
Lastly, the investigators found that fair/worse vision [0.55 (0.34-0.88)] was protective against anxiety.
Expert opinion?
The researchers stated that their study highlights the need for increased awareness regarding MH and support.
Take home.
The findings showed that depressive symptoms are four times more prevalent in individuals with macular disease when their vision is impaired and that symptoms of anxiety and depression often co-occur.