van Nispen Ruth M A, Vreeken Hilde L, Comijs Hannie C, Deeg Dorly J H, van Rens Ger H M B
Department of Ophthalmology, VU University Medical Center, Amsterdam, the Netherlands.
EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, the Netherlands.
Acta Ophthalmol. 2016 Feb;94(1):76-82. doi: 10.1111/aos.12896. Epub 2015 Nov 6.
Although the prevalence of depression in visually impaired older persons is high, the association between vision loss and depression seems to be influenced by factors other than visual impairment. In this study, the role of vision loss, functional limitations and social network characteristics in relation to depressive symptoms was investigated.
Cross-sectional data (N = 1237) from the Longitudinal Aging Study Amsterdam were used to investigate the prevalence of depression (Center of Epidemiological Studies-Depression scale) within subgroups with increasing vision loss. In linear regression models, functional limitations and social network characteristics were examined as possible mediators in the association between vision loss and depression. Having a partner was considered to be a potential moderator.
Although a significant linear trend was found in the presence of depressive symptoms with 14% in normally sighted, 23% in mild and 37% in severe vision loss (χ(2)(1) = 14.9; p < 0.001), vision loss was not an independent determinant of depression. Mediators were functional limitations (p < 0.001) and social network size (p = 0.009). No interaction with partner status was found.
In the presence of depression, a trend was found with increasing severity of vision loss, indicating the need for more attention in (mental) health care and low-vision rehabilitation. In the general older population, vision loss was not an independent determinant of depression but was mediated by functional limitations and social network size. Rather than receiving actual social support, the idea of having a social network to rely on when needed seemed to be associated with lower levels of depression.
尽管视力受损的老年人中抑郁症的患病率很高，但视力丧失与抑郁症之间的关联似乎受到视力障碍以外的因素影响。在本研究中，我们调查了视力丧失、功能限制和社交网络特征与抑郁症状之间的关系。
使用来自阿姆斯特丹纵向老龄化研究的横断面数据（N = 1237），调查视力丧失程度增加的亚组中抑郁症的患病率（流行病学研究中心抑郁量表）。在线性回归模型中，将功能限制和社交网络特征作为视力丧失与抑郁症之间关联的可能中介因素进行检验。有伴侣被认为是一个潜在的调节因素。
尽管在存在抑郁症状方面发现了显著的线性趋势，正常视力者中为14%，轻度视力丧失者中为23%，重度视力丧失者中为37%（χ(2)(1)=14.9；p<0.001），但视力丧失并非抑郁症的独立决定因素。中介因素是功能限制（p<0.001）和社交网络规模（p = 0.009）。未发现与伴侣状况的相互作用。
在存在抑郁症的情况下，发现随着视力丧失严重程度的增加存在一种趋势，这表明在（心理）保健和低视力康复中需要更多关注。在一般老年人群中，视力丧失并非抑郁症的独立决定因素，而是由功能限制和社交网络规模介导。与获得实际社会支持相比，在需要时拥有一个可以依靠的社交网络的想法似乎与较低的抑郁水平相关。
