Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY ; and.
Ocular Surface Disease Clinic, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD.
Cornea. 2024 Dec 1;43(12):1499-1505. doi: 10.1097/ICO.0000000000003516. Epub 2024 Mar 7.
The purpose of this study was to investigate the impact of demographic characteristics and psychiatric comorbidity on the prevalence of dry eye disease in the American geriatric population.
Data were collected from a 2011 nationwide sample of Medicare beneficiaries aged 65 years and older (N = 1,321,000). Age, sex, race/ethnicity, residential area, climate region, and income, along with psychiatric comorbidities including depression and anxiety, were collected. Multivariable logistic regression models were used to assess the relationship between demographic and psychiatric factors and the prevalence of dry eye disease.
Among 21,059 patients with clinically significant dry eye, women had higher odds of having dry eye compared with men [odds ratio (OR) 2.03, 95% confidence interval (1.97-2.10)]. Asian and Native American patients had increased odds of having dry eye compared with White patients [OR 1.85 (1.69-2.02) and OR 1.51 (1.19-1.93)], while Black patients were less likely to have dry eye [OR 0.83 (0.79-0.87)]. Patients aged 75 to 84 years and 85+ were more likely to have dry eye compared with those aged 65 to 74 years [OR 1.49 (0.45-1.53) and OR 1.54 (1.48-1.60)]. Having both depression and anxiety were associated with higher odds of having dry eye [OR 2.38 (2.22-2.55)] compared with having depression alone [OR 1.95 (1.86-2.04)] or anxiety alone [OR 2.22 (2.10-2.35)].
Significant racial and regional disparities in dry eye prevalence were found. Psychiatric association with dry eye varied with age, sex, race, and residence region. Further research is needed to comprehend the underlying mechanisms, implications, and to address disparities in the diagnosis and management of dry eye.
本研究旨在探讨人口统计学特征和精神共病对美国老年人群干眼症患病率的影响。
数据来自于 2011 年全美医疗保险受益人的全国样本，年龄在 65 岁及以上（N=132.1 万）。收集了年龄、性别、种族/民族、居住区域、气候区和收入，以及包括抑郁和焦虑在内的精神共病。采用多变量逻辑回归模型评估人口统计学和精神因素与干眼症患病率之间的关系。
在 21059 例有临床意义的干眼症患者中，女性干眼症的患病几率高于男性[比值比（OR）2.03，95%置信区间（1.97-2.10）]。与白人患者相比，亚洲和美国原住民患者干眼症的患病几率增加[OR 1.85（1.69-2.02）和 OR 1.51（1.19-1.93）]，而黑人患者干眼症的患病几率较低[OR 0.83（0.79-0.87）]。75-84 岁和 85 岁及以上的患者与 65-74 岁的患者相比，干眼症的患病几率更高[OR 1.49（0.45-1.53）和 OR 1.54（1.48-1.60）]。与仅患有抑郁相比，同时患有抑郁和焦虑的患者干眼症的患病几率更高[OR 2.38（2.22-2.55）]，而仅患有焦虑的患者[OR 2.22（2.10-2.35）]。
发现干眼症的患病率存在显著的种族和区域差异。干眼症与精神疾病的关联随年龄、性别、种族和居住区域而变化。需要进一步研究以了解潜在机制、影响，并解决干眼症的诊断和管理方面的差异。
