Vision impairment in older adults tied to symptoms of depression, anxiety and social isolation: JAMA

These findings, published in JAMA Ophthalmology, provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.

Vision impairment and psychosocial function, including symptoms of anxiety, depression and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies evaluating associations between subjective and objective vision impairment with psychosocial function following the COVID-19 pandemic.

To address this knowledge gap, Louay Almidani, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, and colleagues provided updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older.

The study was a cross-sectional analysis of the National Health and Aging Trends Study rounds 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and above. Binocular distance visual acuity, contrast sensitivity, and near visual acuity were tested.

Objectively measured vision impairment was defined as vision impairment in either distance visual acuity (worse than 20/40), near visual acuity (worse than 20/40), or contrast sensitivity (worse than 1.55 logCS). Self-reported vision impairment was defined based on participants’ reports on their vision status.

Depression and anxiety symptoms were assessed via the Patient Health Questionnaire. Social isolation was defined based on communication frequency, living arrangement, and activity participation responses.

The researchers reported the following findings:

• Among 2822 community-dwelling adults sampled from a population of 26 182 090, the mean age was 78.5 years; 54.7% were female; 32.3% had objectively measured vision impairment, and 6.4% had self-reported vision impairment.
• In adjusted models, all outcomes were significantly associated with objectively measured vision impairment, including depressive symptoms (odds ratio [OR], 1.81), anxiety symptoms (OR, 1.74), and severe social isolation (OR, 2.01).
• Depressive symptoms (OR, 2.37) and anxiety symptoms (OR, 2.10) but not severe social isolation symptoms (OR, 2.07) were significantly associated with self-reported vision impairment.

In the study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression, anxiety and social isolation.

Reference:

Almidani L, Miller R, Varadaraj V, Mihailovic A, Swenor BK, Ramulu PY. Vision Impairment and Psychosocial Function in US Adults. JAMA Ophthalmol. Published online February 22, 2024. doi:10.1001/jamaophthalmol.2023.6943