Elsevier

Ophthalmology

Volume 110, Issue 4, April 2003, Pages 651-657
Ophthalmology

Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment

https://doi.org/10.1016/S0161-6420(02)01901-2Get rights and content

Abstract

Purpose

To determine the feasibility of screening for depression, dementia, and functional impairment in an ophthalmology outpatient clinic.

Design

Prospective pilot survey study.

Participants

Fifty consecutive ophthalmology clinic outpatients.

Methods

Consecutive patients more than 64 years of age with visits to the comprehensive eye clinic and the neuroophthalmology clinic at the University of Iowa were assessed. Suitable subjects were asked to complete a short questionnaire on instrumental activities of daily living, to answer a single question on depression, and to complete a clock drawing task in the office waiting room or examination room.

Results

The 50 questionnaires reviewed showed that most respondents were functional (94%) in instrumental activities of daily living, had normal clock drawing results (80%), and were not depressed (80%). A significant minority, however, were identified by the screening to have functional impairment (6%), abnormal clock drawing results (20%), or depression (20%), and these patients were offered geriatric assessment. The tests were rapid (fewer than 5 minutes to perform) and easy to administer.

Conclusions

Screening for geriatric syndromes in the eye clinic was rapid, easy to perform, and detected a significant number of patients with functional disability, depression, and possible dementia.

Section snippets

Patients and methods

Consecutive outpatients seen in the comprehensive and neuroophthalmology clinics of the Department of Ophthalmology at the University of Iowa Hospitals and Clinics were evaluated from January 2001 through March 2001. Inclusion criteria were: all patients more than 64 years of age making visits to the comprehensive eye clinic or the neuroophthalmology clinic at the University of Iowa. Informed consent was obtained from all patients before the administration of the questionnaire in accordance

Results

Fifty patients met inclusion criteria. The reasons that patients were excluded from our study included: refusal to participate in the study (did not sign the informed consent), deemed by the screening physician to be unable to perform the test (e.g., completely blind patients, non–English-speaking patients or otherwise unable to understand directions of informed consent), and incomplete, unsigned consents or illegible or incomplete forms (four patients). Of the 50 questionnaires reviewed, most

Discussion

Screening for depression, dementia, or functional impairment in the elderly may lead to appropriate intervention and improved quality of life. Geriatricians have been performing these screenings for years. The ophthalmology clinic may be an ideal nongeriatric specialty clinic to perform outpatient screening for geriatric syndromes. First, the ophthalmology population tends to be composed of older individuals. Second, there is a relatively high volume of ambulatory patients in an outpatient eye

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    Manuscript no. 210643.

    Supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York.

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