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October 27, 2021
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Impaired vision tied to depressive symptoms in women during midlife

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Vision impairment may increase risk for future depressive symptoms among women during midlife, according to study results published in Menopause: The Journal of The North American Menopause Society.

“Despite [the] demonstrable increase in the prevalence of both depression and common eye disorders that can compromise vision during midlife, knowledge about the impact of vision on depressive symptoms among midlife adults is limited,” Carrie A. Karvonen-Gutierrez, PhD, MPH, of the department of epidemiology at the University of Michigan School of Public Health, and colleagues wrote. “Several studies have reported that [vision impairment] has a negative impact on psychological well-being yet precise estimates among midlife populations are lacking due to the limited number of studies that assessed midlife vision and depression.

infographic with percentage of women in midlife who have vision impairment
Infographic data derived from: Karvonen-Gutierrez CA, et al. Menopause. 2021;doi:10.1097/GME.0000000000001880.

“Furthermore, the nature of the longitudinal association and directionality of the relationship between [vision impairment] and depression among midlife adults is largely unknown,” they added.

The researchers analyzed data of 226 women (mean age at analytic baseline, 50 years) included in the Michigan site of the Study of Women’s Health Across the Nation, which assessed distance visual acuity at six consecutive, approximately yearly follow-up visits. Participants provided data on depressive symptoms via the Center for Epidemiological Studies-Depression Scale at each visit. Visual acuities of 20/30 to 20/60 and 20/70 or worse signaled mild or moderate-severe impairment, respectively. Further, the researchers assessed the link between vision impairment and reported depressive symptoms at the subsequent visit using multivariable logistic regression models that incorporated generalized estimating equations.

Results showed mild and moderate-severe vision impairment among 53.5% and 8% of women, respectively. Those with mild and moderate-severe vision impairment had 68% and 2.55-fold higher likelihood of reporting depressive symptoms at their subsequent visits than women without vision impairment, after adjusting for age, preexisting depressive symptoms, race, education, economic strain, BMI and smoking. The associations were attenuated and no longer statistically significant after additional adjustment for diabetes, hypertension and osteoarthritis.

“The complex and bidirectional nature of the relationship between depression and [vision impairment] could potentially lead to a vicious cycle,” Karvonen-Gutierrez and colleagues wrote. “Thus, early identification and timely correction of vision problems is an important step in preserving mental and physical health among midlife women.”