Explaining the relationship between three eye diseases and depressive symptoms in older adults.

PURPOSE: The purpose of this study is to examine whether patients with age-related eye diseases, like age-related macular degeneration (AMD), glaucoma, or Fuchs corneal dystrophy, are more likely to show signs of depression compared to a control group of older adults with good vision, and to determine whether reduced mobility mediates these relationships. METHODS: We recruited 315 eligible patients (81 with AMD, 55 with Fuchs, 91 with glaucoma, and 88 controls) from the ophthalmology clinics of a Montreal hospital from September 2009 until December 2011. Depressive symptoms were assessed using the Geriatric Depression Scale Short Form (GDS-15). Life space was measured using the Life Space Assessment. Logistic regression was used to adjust for demographic, health, and social factors, and mediation was assessed using the methods of Baron and Kenny. RESULTS: There were 78 people (25%) meeting the criteria for depression in the cohort. All three groups with eye disease were more likely to be depressed than the control group after adjusting for age, sex, ethnicity, education, cognitive score, limitations in activities of daily living, social support, and lens opacity (P < 0.05). Life space and limited activities due to a fear of falling appeared to mediate the relationship between eye disease and depression. CONCLUSIONS: Visually limiting eye disease is associated with depression in older adults. Further research on interventions to prevent depression in patients with eye disease is warranted and should consider strategies to alleviate mobility limitation. Greater attention from families, physicians, and society to the mental health needs and mobility challenges of patients with eye disease is needed.

Age-related eye disease and mobility limitations in older adults.

PURPOSE: To examine the extent of mobility limitations in patients with age-related macular degeneration (AMD), glaucoma, or Fuchs' corneal dystrophy compared with that in a control group of older adults with good vision. METHODS: Two hundred seventy-two patients (68 with AMD, 49 with Fuchs' dystrophy, 82 with glaucoma, and 73 controls) from the ophthalmology clinics of Maisonneuve-Rosemont Hospital (Montreal, Canada) participated in a cross-sectional study from September 2009 until February 2011. Control patients who had normal visual acuity and visual fields were recruited from the same clinics. Questionnaire (life space, falls, and driving) and performance-based (one-legged balance test, Timed Up and Go [TUG] test) mobility data were collected; visual acuity, contrast sensitivity, and visual field were measured; and the medical record was reviewed. RESULTS: The three eye diseases were associated with different patterns of mobility limitations. Patients with glaucoma had the most types of mobility limitations, as they had reduced life-space scores, had worse TUG scores, were less likely to drive, and were more likely to have poor balance than the control group (P < 0.05). Compared with the controls, patients with AMD and Fuchs' corneal dystrophy had reduced life-space scores and were less likely to drive (P < 0.05). CONCLUSIONS: The results suggest that eye diseases, especially glaucoma, restrain the mobility of older people in many different ways. It is important to further explore the impact of eye disease on mobility in this population, to develop interventions that could help affected older adults maintain their independence.

Prevalence and risk factors for near and far visual difficulty in Burkina Faso.

PURPOSE: To determine the prevalence and risk factors for near and far visual difficulty in Burkina Faso. METHODS: Population-based data were used from the World Health Survey done in Burkina Faso in 2002-2003;2003 (n=4,822 adults). Near and far visual difficulty were assessed by questions about difficulty seeing and recognizing an object at arm's length and about difficulty seeing and recognizing a person across the road. Prevalence estimates were adjusted for the multi-stage, stratified, random cluster sampling design. Logistic regression was used to identify independent risk factors. RESULTS: The overall prevalence of any near and far visual difficulty was 10% (standard error [SE] = 0.7%) and 13% (SE=0.9%) respectively. Prevalence estimates were strongly associated with age with 48% (SE=4.2%) and 66% (SE=3.9%) of those >or= 65 years old having near or far visual difficulty (P < 0.001). Only 5% (SE=0.6%) of people wore glasses. We identified two potentially modifiable variables associated with near visual difficulty: a cooking stove in the same room as sleeping area (Odds Ratio [OR]=1.45, 95% Confidence Interval [CI] 1.01, 2.02) and high fruit consumption (OR=0.65, 95% CI 0.50, 0.86). CONCLUSION: The prevalence of visual difficulty was high in Burkina Faso. Efforts to confirm these findings with cooking stove location and fruit consumption should be undertaken in this population.