High vision-related quality of life indices reduce the odds of depressive symptoms in aged care facilities

Contact Information

Keywords

Ecosse Lamoureux，ecosse.lamoureux@seri.com.sg

Depression; aged care; emotional well-being; quality of life; vision impairment.

Abstract

Objective: To examine the association between vision-related quality of life (VRQoL) and depressive symptoms in residents with vision impairment (VI) in aged care facilities.Methods: In this cross-sectional study using baseline data from a cluster-randomized controlled trial (ACTRN12615000587505) assessing the effectiveness of a novel eye care model, 186 English-speaking residents (mean age 84 years, SD[standard deviation] = 8.7; 33.9% male) with VI and moderate cognitive functioning or better were recruited from 38 facilities across Victoria, Australia. VRQoL was measured using Rasch-transformed scores from the 'Reading'; 'Mobility', and 'Emotional' scales of the Impact of Vision Impairment for Residential Care (IVI-RC) questionnaire. Outcomes were presence of depressive symptoms (binary score: Cornell Scale for Depression in Dementia [CSDD] > 0 vs. CSDD = 0) and severity of depressive symptoms (continuous CSDD score; sample range 1-21). Independent associations with presence and severity of depressive symptoms were examined using zero-inflated logistic and linear multivariable models, respectively.Results: Of the 186 participants, n = 79 (42.5%), n = 94 (50.5%) and n = 13 (7%) reported no, mild (scores 1-7), and clinically significant depressive symptoms (score ≥8), respectively. Better vision-related Mobility (OR = 0.64; 95% CI: 0.44, 0.95, p = 0.02) was associated with reduced odds of depressive symptoms. With every unit improvement in vision-related Reading (β=-0.48; 95% CI: -0.94, -0.01, p = 0.04) and Emotional (β=-0.56; 95% CI: -1.09, -0.02, p = 0.04), severity of depressive symptoms reduced, independent of sociodemographic and medical issues.Conclusion: Better VRQoL was independently associated with reduced depressive symptoms. Supporting older people in aged care to maintain optimal levels of vision-specific functioning, independence, and emotional well-being may protect their mental health.

Citation

Rees, G., McCabe, M., Xie, J., Constantinou, M., Gan, A., Holloway, E., Man, R. E., Jackson, J., Fenwick, E. K., & Lamoureux, E. (2020). High vision-related quality of life indices reduce the odds of depressive symptoms in aged care facilities. Aging & mental health, 24(10), 1596–1604. https://doi.org/10.1080/13607863.2019.1650889

DOI

10.1080/13607863.2019.1650889

EWB Constructs:

(4) quality of life;

EWB Measures:

(1) Vision-related Quality of Life
(2) General health status was assessed with the EuroQoL 5-Dimension 3-level (EQ-5D-3L)

data availability:

Yes

data availability details:

Data sets relating to this paper can be made available upon reasonable request from the corresponding author.

brain imaging paradigm:

N/A

brain region/circuit:

Exclusion Criteria:

(i) Presenting distance vision of 6/12 or better and/or Near vision of better than N8 in both eYes
(ii) Inability to speak English
(iii)People with a cognitive impairment as determined by the Psychogeriatric Assessment Scale (PAS) questionnaire. A score of >15 in the PAS is deemed ineligible.
(iii) Non-english speaking residents
(iv) inability to be tested for vision
(v) contraindication(s) as indicated by general practitioner responsible for residents care.

Inclusion Criteria

(i) Presenting distance vision of 6/15 or less and/or Near vision of N8 or less in both eYes
(ii) Ability to speak English
(iii) People deemed not cognitively impaired as determined by the Psychogeriatric Assessment Scale (PAS) questionnaire. A score of <15 in the PAS is deemed eligible.
(iv) Ability to undergo visual acuity testing and provide reliable results

Non-EWB Behavioral
Measures:

(1) Depressive symptoms: the Cornell
Scale for Depression in Dementia (CSDD)
(2) Vision assessment
(3) Quality of vision Scale

First author:

Gwyneth Rees

species:

Human

sample size:

186

study design:

(1) cross-sectional

longitudinal data?

younger controls?

interventions:

N/A

study population:

(1) cognitively healthy adults;
(2) patients with (pre)clinical dementia ;
(3) patients with other mental health disorders than dementia

sex (% female):

66.10%

ethnicity (%white)

not stated (Australia)

Age (mean, sd):

84, 8.7

biological/Physiological Measures:

(4) other: Vision assessment