Korean J Ophthalmol.  2017 Oct;31(5):412-423. 10.3341/kjo.2016.0086.

Depressive Symptoms and Quality of Life in Age-related Macular Degeneration Based on Korea National Health and Nutrition Examination Survey (KNHANES)

Affiliations
  • 1Department of Ophthalmology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea. hycho@hanyang.ac.kr
  • 2Department of Ophthalmology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
  • 3Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

PURPOSE
This study was conducted to investigate the depressive symptoms and quality of life (QOL) in patients with age-related macular degeneration (AMD) using data obtained from the Korea National Health and Nutritional Examination Survey V-2 (KNHANES V-2) conducted in 2011.
METHODS
This was a population-based, cross-sectional study that selected 329 participants from the fifth KNHANES (2011) who were diagnosed with AMD by an ophthalmologist based on fundus photography. The prevalence of depressive symptoms and the health-related QOL (using EuroQol indices) in this cohort were also estimated. Factors associated with depressive symptoms, including socioeconomic status, QOL indices, and associated chronic diseases, were investigated using multivariate regression models.
RESULTS
Depressive symptoms were observed more frequently in AMD patients than in non-AMD controls (p = 0.013). Among the total 329 AMD participants, 65 (19.8%) had depressive symptoms. There were 16 males (24.6%) and 49 females (75.4%). Upon multivariate analysis, significant factors found to be associated with depressive symptoms were female gender (odds ratio [OR], 2.082; 95% confidence interval [CI], 1.001 to 4.330), being in the "dependent" group for activities of daily living (OR, 4.638; 95% CI, 2.061 to 10.435), and having "some problems" in the "anxiety-depression" dimension of the EQ-5D (OR, 7.704; 95% CI, 1.890 to 31.408).
CONCLUSIONS
Female gender and being dependent on others for activities of daily living increased the association of depressive symptoms in this cohort of AMD participants. Screening for depressive symptoms in East Asian AMD patients with these characteristics should be an important component of their care.

Keyword

Age-related macular degeneration; Depression; Korea National Health and Nutritional Examination Survey; Quality of life

MeSH Terms

Activities of Daily Living
Asian Continental Ancestry Group
Chronic Disease
Cohort Studies
Cross-Sectional Studies
Depression*
Female
Humans
Korea*
Macular Degeneration*
Male
Mass Screening
Multivariate Analysis
Nutrition Surveys*
Photography
Prevalence
Quality of Life*
Social Class

Figure

  • Fig. 1 Flow diagram of the study participants. KNHANES = Korea National Health and Nutrition Examination Survey; AMD = age-related macular degeneration.

  • Fig. 2 Distribution of perceived problem level in each dimension of the EQ-5D descriptive system for the age-related macular degeneration (AMD) and non-AMD groups. Significance level between patients both with and without AMD according to chi-square test.


Reference

1. Klein R, Klein BE, Jensen SC, Meuer SM. The five-year incidence and progression of age-related maculopathy: the Beaver Dam Eye Study. Ophthalmology. 1997; 104:7–21.
2. Pascolini D, Mariotti SP, Pokharel GP, et al. 2002 Global update of available data on visual impairment: a compilation of population-based prevalence studies. Ophthalmic Epidemiol. 2004; 11:67–115.
3. Kawasaki R, Yasuda M, Song SJ, et al. The prevalence of age-related macular degeneration in Asians: a systematic review and meta-analysis. Ophthalmology. 2010; 117:921–927.
4. Song SJ, Youm DJ, Chang Y, Yu HG. Age-related macular degeneration in a screened South Korean population: prevalence, risk factors, and subtypes. Ophthalmic Epidemiol. 2009; 16:304–310.
5. Casten R, Rovner B. Depression in age-related macular degeneration. J Vis Impair Blind. 2008; 102:591–599.
6. Banerjee A, Kumar S, Kulhara P, Gupta A. Prevalence of depression and its effect on disability in patients with age-related macular degeneration. Indian J Ophthalmol. 2008; 56:469–474.
7. Brody BL, Gamst AC, Williams RA, et al. Depression, visual acuity, comorbidity, and disability associated with age-related macular degeneration. Ophthalmology. 2001; 108:1893–1900.
8. Jivraj J, Jivraj I, Tennant M, Rudnisky C. Prevalence and impact of depressive symptoms in patients with age-related macular degeneration. Can J Ophthalmol. 2013; 48:269–273.
9. Rovner BW, Casten RJ, Tasman WS. Effect of depression on vision function in age-related macular degeneration. Arch Ophthalmol. 2002; 120:1041–1044.
10. Lee WJ, Cho HY, Kim DH, et al. Depression of late age-related macular degeneration patients in Korea. Asia Pac J Ophthalmol (Phila). 2013; 2:23–27.
11. Cahill MT, Banks AD, Stinnett SS, Toth CA. Vision-related quality of life in patients with bilateral severe age-related macular degeneration. Ophthalmology. 2005; 112:152–158.
12. Coleman AL, Yu F, Ensrud KE, et al. Impact of age-related macular degeneration on vision-specific quality of life: follow-up from the 10-year and 15-year visits of the Study of Osteoporotic Fractures. Am J Ophthalmol. 2010; 150:683–691.
13. Piermarocchi S, Varano M, Parravano M, et al. Quality of vision index: a new method to appraise visual function changes in age-related macular degeneration. Eur J Ophthalmol. 2011; 21:55–66.
14. Slakter JS, Stur M. Quality of life in patients with age-related macular degeneration: impact of the condition and benefits of treatment. Surv Ophthalmol. 2005; 50:263–273.
15. Korea Centers for Disease Control and Prevention. Korea National Health and Nutrition Examination survey raw material guideline [Internet]. Cheongju: Korea Centers for Disease Control and Prevention;2010. cited 2017 Jun 20. Available from: http://knhanes.cdc.go.kr/.
16. Ha JY, Kim ES, Kim HJ, Park SJ. Factors associated with depressive symptoms in patients with chronic low back pain. Ann Rehabil Med. 2011; 35:710–718.
17. Kim SH, Kim JS, Choi JY, et al. Factors associated with depressive symptom in chronic obstructive pulmonary disease based on the third (2005) and fourth (2008) Korea National Health and Nutritional Examination Survey (KNHANES III, IV). Korean J Fam Med. 2011; 32:234–242.
18. Brooks R. EuroQol: the current state of play. Health Policy. 1996; 37:53–72.
19. EuroQol Group. EuroQol: a new facility for the measurement of health-related quality of life. Health Policy. 1990; 16:199–208.
20. Nam HS, Kim KY, Kwon SS, editors. EQ-5D Korean valuation study using time trade off method. Seoul: Korea Centers for Disease Control and Prevention;2007.
21. Bird AC, Bressler NM, Bressler SB, et al. The International ARM Epidemiological Study Group. An international classification and grading system for age-related maculopathy and age-related macular degeneration. Surv Ophthalmol. 1995; 39:367–374.
22. Jin YH. A new logMAR vision chart: Jin's vision chart. J Korean Ophthalmol Soc. 1997; 38:2036–2044.
23. Blazer DG. Depression in late life: review and commentary. J Gerontol A Biol Sci Med Sci. 2003; 58:249–265.
24. Cho MJ, Lee JY, Kim BS, et al. Prevalence of the major mental disorders among the Korean elderly. J Korean Med Sci. 2011; 26:1–10.
25. Kim JM, Stewart R, Shin IS, et al. Lifetime urban/rural residence, social support and late-life depression in Korea. Int J Geriatr Psychiatry. 2004; 19:843–851.
26. Cho MJ, Nam JJ, Suh GH. Prevalence of symptoms of depression in a nationwide sample of Korean adults. Psychiatry Res. 1998; 81:341–352.
27. de Groot M, Anderson R, Freedland KE, et al. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001; 63:619–630.
28. Glassman AH, Shapiro PA. Depression and the course of coronary artery disease. Am J Psychiatry. 1998; 155:4–11.
29. Simon GE. Treating depression in patients with chronic disease: recognition and treatment are crucial--depression worsens the course of a chronic illness. West J Med. 2001; 175:292–293.
30. Rovner BW, Casten RJ, Hegel MT, et al. Low vision depression prevention trial in age-related macular degeneration: a randomized clinical t rial. Ophthalmology. 2014; 121:2204–2211.
31. Watkins C, Daniels L, Jack C, et al. Accuracy of a single question in screening for depression in a cohort of patients after stroke: comparative study. BMJ. 2001; 323:1159.
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