Original Article
Prevalence and impact of depressive symptoms in patients with age-related macular degeneration

https://doi.org/10.1016/j.jcjo.2013.03.007Get rights and content

Abstract

Objective

This study sought to identify the point prevalence of depressive symptoms, quality-of-life (QOL) impairment, and demographic parameters associated with depression in patients with age-related macular degeneration (AMD) attending a retina clinic in Edmonton, Alberta.

Design

A cross-sectional design was used.

Methods

Consecutive patients with AMD were invited to participate in the study. Demographic data, as well as ophthalmic, medical, and psychiatric histories, were collected. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and the Visual Function Questionnaire (VFQ-25) scales to quantify the burden of depressive symptoms and vision-related QOL impairment.

Results

The study enrolled 101 patients, of whom 7 (6.9%) had a previous history of depression. Twenty (21.3%) of the remaining patients endorsed severe symptoms of depression that had not yet been diagnosed. Significant differences in vision-related QOL between depressed and not depressed patients were identified. Depressed patients were also found to have worse visual acuity (p = 0.047) and were less likely to live with others (p = 0.020) than those who were not depressed.

Conclusions

After excluding patients with a history of diagnosed depression, 20 (21.3%) patients demonstrated severe symptoms of depression. Development of depression screening protocols for patients with AMD would improve identification and referral of patients at risk. The finding that patients who lived with others had a lower prevalence of depressive symptoms suggests that further research into the relationship between mood symptoms and environmental supports is merited.

Résumé

Objet

Cette étude cherche à identifier la prévalence ponctuelle des symptômes de dépression, des pertes de qualité de vie et des paramètres démographiques associés à la dépression des patients ayant une dégénérescence maculaire liée à l'âge (DMLA), en attente dans une clinique de la rétine d'Edmonton, Alberta.

Nature

Analyse transversale.

Méthodes

Des patients consécutifs ayant une DMA ont été invités à participer à cette étude. Les données démographiques ainsi que les antécédents ophtalmiques, médicaux et psychiatriques ont été colligés. Les patients ont complété les échelles du Center for Epidemiologic Studies Depression Scale (CES-D) et du Visual Function Questionnaire (VFQ-25) pour évaluer l'ampleur du poids des symptômes de dépression et la qualité de vie quant à la vision.

Résultats

101 patients ont participé à l'étude et sept d'entre eux (6,9 %) avaient des antécédents de dépression. Vingt (21,3 %) des autres patients ont confirmé de graves symptômes de dépression qui n'avaient pas encore été diagnostiqués. Des écarts significatifs de qualité de vie quant à la vision entre les patients déprimés et non déprimés ont été identifiés. L'on a aussi constaté que les patients déprimés avaient la pire acuité visuelle (p = 0,047) et étaient moins enclins à vivre avec ceux (p = 0,020) qui n'étaient pas déprimés.

Conclusions

Après l'exclusion des patients avec antécédents de dépression diagnostiquée, vingt (21,3 %) en ont démontré des symptômes sévères. Le développement de protocoles de dépistage de dépression chez les patients atteints de DMLA améliorerait l'identification et l'orientation des patients à risque. La découverte de patients qui, vivant avec d'autres personnes, manifestaient moins de symptômes de dépression indique qu'il vaut la peine de poursuivre les recherches sur le rapport entre les symptômes d'humeur et le soutien environnemental.

Section snippets

Methods

The study protocol was approved by the University of Alberta Research Ethics Board. Patients with the following characteristics were invited to participate in the study: (i) age older than 65 years; (2) presented to the Alberta Retina Consultants office between November 1, 2009, and February 29, 2010, with a diagnosis of AMD; and (3) fluent in English. Patients who had a preexisting diagnosis of depression were excluded. Each patient provided informed consent before participating in the study.

Results

Of 103 patients eligible to participate, the Mini-Mental Status Examination indicated that 2 were cognitively impaired and were, therefore, excluded from the study. Seven patients (6.9%) had a preexisting diagnosis of depression and were also excluded. A total of 94 patients constituted the final study population. The average age of the participants was 80.4 ± 6.8 years and 65 (69.2%) were female. No patients disclosed other past psychiatric conditions or a diagnosis of dementia.

Twenty (21.3%)

Conclusion

Depression was common in a cohort of patients with AMD. Given that the most important independent protective factors were living with others (OR 0.17) and higher composite VFQ scores (OR 0.925), ophthalmologists may consider using these findings to determine which patients should undergo further assessment by their primary care physicians for depression. In addition, the use of rapid, patient-completed questionnaires administered during the longitudinal encounter between patient and

Disclosure

The authors have no proprietary or commercial interest in any materials discussed in this article.

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  • Cited by (0)

    Recipient of the 2011 Canadian Ophthalmology Society Award for Excellence in Ophthalmic Research (poster award).

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