OBJECTIVE: To assess how depression and impaired
vision relate to disability in older people.
DESIGN:
An epidemiological survey of an age-stratified random
community sample.
SETTING: The rural
mid-Monongahela Valley in South-western Pennsylvania.
PARTICIPANTS: A total of 872 noninstitutionalized
persons aged 68 and older, fluent in English, and with
at least a grade 6 education.
MEASUREMENTS:
Demographics, self-reported vision impairment, OARS
Instrumental Activities of Daily Living (IADL), and
modified Center for Epidemiologic Studies-Depression
scale to assess depression.
RESULTS: Compared
with subjects with intact vision, those with impaired
vision were more likely to have five or more depressive
symptoms (29.7% vs 8.5%; OR = 4.6, 95% CI = 2.2, 9.6)
and to be more functionally impaired (OR = 9.7, 95% CI =
4.9, 19.2). The number of depressive symptoms (1-4: OR =
2.4, CI = 1.8, 3.4) and (5+: OR = 5.9, CI = 3.6, 9.8)
was associated independently with IADL impairment after
controlling for vision, age, and gender.
CONCLUSIONS:
Impaired vision and depression are both associated
strongly with functional impairment in this community
population of older adults. Depression, however,
increases the odds of functional impairment independent
of vision impairment. Treating depression may reduce
excess disability associated with impaired vision.