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

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.

Keywords:

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

Acknowledgements

The authors would like to extend thanks to Theona Nicolaou and Kiera Young for their research coordination efforts in the study, Associate Professor Sharon Bentley for her role in coordinating optometric input to the study at the Australian College of Optometry (ACO) and the ACO Study Optometrists Lauren Kharsas, Lesley Dacion, Vianh Huynh and Hee Wei Yii for the clinical examination of residents. We would also like to acknowledge the residential care facilities staff and residents of Mercy Health Residential Aged Care and Aged Care Services Australia Group.

Disclosure statement

The authors report no conflict of interest.

Data availability statement

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

Additional information

Funding

This work was supported by the National Health and Medical Research Council [grant number 1046689], National Health and Medical Research Council Senior Research Fellowship to E.L. [grant number 1045280], and operational infrastructure support from the Victorian Government. The sponsor or funding organization had no role in the design, execution, analysis and interpretation of data, or writing of the study.