A prospective study of the bi-directional association between vision loss and depression in the elderly
A prospective study of the bi-directional association between vision loss and depression in the elderly
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DOI：
10.1016/j.jad.2013.05.071
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发表时间：
2013-10-01
影响因子：
6.6
通讯作者：
Ritchie, Karen
中科院分区：
文献类型：
--
作者：
Carriere, Isabelle;Delcourt, Cecile;Ritchie, Karen
背景：随着年龄的增长，视力障碍（VI）的增加与心理健康问题有关，但时间方向和反向因果关系的问题以前尚未得到解决。我们的目的是前瞻性地研究老年人 VI 和视功能 (VF) 丧失与抑郁症状的双向关联。方法：该队列由 4216 名 65 岁及以上的参与者（40.2% 男性）组成，并进行了 10 年的随访。近 VI 是使用测量的通常校正双眼视力来定义的，而远 VF 是自我声明的。患有重度抑郁发作或流行病学研究中心抑郁量表评分≥16的参与者被归类为具有抑郁症状。纵向分析使用混合逻辑模型进行重复评估。结果：调整人口因素后，基线时中度至重度接近 VI 的参与者出现抑郁症状的几率增加（比值比 [OR]=1.60；95% 置信区间 [CI]-1.08-2.38），但经过多次调整后，关联性降至显着性水平以下。距离 VF 的 2 年减少与多次调整后随访期间抑郁症状的几率增加相关（OR=3.03；95% CI=1.75-5.23）。基线抑郁症状与 VI 附近的事件无关，但在多变量调整后与 VF 丧失相关（OR=1.62；95% CI=1.15-2.28）。局限性：VI 的原因尚未记录。结论：视力丧失与抑郁症状发作的关系根据 VI 附近或距离 VF 的不同而不同，并且随着时间的推移而下降。在基线抑郁与距离 VF 的事件丧失之间发现反向强关联，表明呈螺旋式下降。的事件。 (C) 2013 Elsevier B.V. 保留所有权利。
Background: Increasing visual impairment (VI) with age has been associated with mental health problems but the question of temporal direction and reverse causality has not been addressed previously. Our objective was to prospectively examine the bi-directional association of VI and visual function (VF) loss with depressive symptoms in the elderly.Methods: The cohort comprised 4216 participants (40.2% men) aged 65 and over with 10 years of follow-up. Near VI was defined using measured usual-corrected binocular acuity while distance VF was self-declared. Participants having a major depressive episode or a Center for Epidemiologic Studies Depression Scale score >= 16 were classified as having depressive symptomatology. Longitudinal analyses used mixed logistic models for repeated evaluations.Results: After adjustment for demographic factors, participants with moderate to severe near VI at baseline had increased odds of developing depressive symptomatology (Odds Ratio [OR]=1.60; 95% Confidence Interval [CI]-1.08-2.38), but after multiple adjustments the association fell below the significance level. A 2-year decrease in distance VF was associated with increased odds of depressive symptomatology during follow-up after multiple adjustments (OR=3.03; 95% CI=1.75-5.23). Baseline depressive symptomatology was not associated with incident near VI but was associated with VF loss after multivariate adjustment (OR=1.62; 95% CI=1.15-2.28).Limitations: The causes of VI have not been recorded.Conclusions: The relation of vision loss to onset of depressive symptomatology differs according to near VI or distance VF and declines across time A reverse strong association was found between baseline depression and incident loss of distance VF suggesting a downward spiral of events. (C) 2013 Elsevier B.V. All rights reserved.