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- Title
Vision Impairment and Psychosocial Function in US Adults.
- Authors
Almidani, Louay; Miller, Rhonda; Varadaraj, Varshini; Mihailovic, Aleksandra; Swenor, Bonnielin K.; Ramulu, Pradeep Y.
- Abstract
Key Points: Question: What are the associations of vision impairment with depressive and anxiety symptoms and social isolation among adults 65 years and older? Findings: In this cross-sectional study including 2822 US adults, worse examination-based and self-reported vision impairment were associated with depressive and anxiety symptoms, and worse examination-based vision impairment was associated with severe social isolation. Meaning: These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment. This cross-sectional study evaluates associations between vision impairment and psychosocial outcomes in US adults. Importance: Vision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic. Objective: To provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older. Design, Setting, and Participants: This was a cross-sectional analysis of the National Health and Aging Trends Study round 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and older. Binocular distance visual acuity, near visual acuity, and contrast sensitivity were tested. Objectively measured vision impairment was defined as having 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' report on their vision status. Data were analyzed in May 2023. Main Outcomes and Measures: Depressive and anxiety symptoms assessed via the Patient Health Questionnaire. Social isolation was defined based on living arrangement, communication frequency, and activity participation responses. Results: Among 2822 community-dwelling adults sampled from a population of 26 182 090, the mean (SD) age was 78.5 (5.6) years; 1605 individuals (54.7%) were female; 1077 (32.3%) had objectively measured vision impairment, and 203 (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; 95% CI, 1.26-2.58), anxiety symptoms (OR, 1.74; 95% CI, 1.13-2.67), and severe social isolation (OR, 2.01; 95% CI, 1.05-3.87). Similarly, depressive symptoms (OR, 2.37; 95% CI, 1.44-3.88) and anxiety symptoms (OR, 2.10; 95% CI, 1.09-4.05) but not severe social isolation symptoms (OR, 2.07; 95% CI, 0.78-5.49) were significantly associated with self-reported vision impairment. Conclusions and Relevance: In this study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression and anxiety and social isolation. These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.
- Publication
JAMA Ophthalmology, 2024, Vol 142, Issue 4, p283
- ISSN
2168-6165
- Publication type
Article
- DOI
10.1001/jamaophthalmol.2023.6943