Longitudinal association of midlife vision impairment and depressive symptoms: the study of Women's Health Across the Nation, Michigan site : Menopause

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Longitudinal association of midlife vision impairment and depressive symptoms: the study of Women's Health Across the Nation, Michigan site

Karvonen-Gutierrez, Carrie A. PhD, MPH; Kumar, Navasuja MBBS, MPH; Hood, Michelle M. MS; Musch, David C. PhD, MPH; Harlow, Sioban PhD; Moroi, Sayoko E. MD, PhD

Author Information

1Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI

2Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI

3Department of Ophthalmology and Visual Sciences, Michigan Medicine, University of Michigan, Ann Arbor, MI

4Department of Ophthalmology and Visual Sciences, Havener Eye Institute, The Ohio State University Wexner Medical Center, Columbus, OH.

Address correspondence to: Carrie A. Karvonen-Gutierrez, PhD, MPH, School of Public Health, University of Michigan, 1415 Washington Heights, Room 6618, Ann Arbor, MI 48109. E-mail: [email protected]

Received 3 March, 2021

Revised 12 August, 2021

Accepted 12 August, 2021

Funding/support: The Study of Women's Health Across the Nation (SWAN) has grant support from the National Institutes of Health (NIH), DHHS, through the National Institute on Aging (NIA), the National Institute of Nursing Research (NINR) and the NIH Office of Research on Women's Health (ORWH) (Grants U01NR004061; U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495). The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the NIA, NINR, ORWH, or the NIH.

This work was additionally supported by a grant from the National Institutes of Health (NIH), DHHS, through the National Eye Institute (R21EY030363 (D.C.M., S.E.M.), by NIA R01AG017104 (Michigan SWAN Strength & Functioning Study), and University of Michigan MCubed (S.E.M., C.A.K.-G.). This study was additionally supported by R01AG017104 (Michigan SWAN site-specific study), R21EY030363, and University of Michigan MCubed support.

Financial disclosure/conflicts of interest: D.C.M. receives funding from Applied Genetic Technologies Corporation, ClinReg Consulting, ONL Therapeutics, Inc, and Editas Medicine, Inc. S.E.M. receives funding from the NIH for unrelated research, NSF for unrelated research; and has received industry support for glaucoma pharmacology trials while at University of Michigan (Allergan) and book royalties for Shields Textbook of Glaucoma, 6th ed. The other authors have nothing to disclose.

Supplemental digital content is available for this article. Direct URL citations are provided in the HTML and PDF versions of this article on the journal's Website (www.menopause.org).

Menopause 29(1):p 35-41, January 2022. | DOI: 10.1097/GME.0000000000001880

Abstract

Objective: 

Poor vision affects physical health but the relationship with depressive symptoms among midlife adults (40-65 y), who often present with early stage vision impairment (VI), is not well understood. The goal of this study was to assess the impact of vision on depressive symptoms during midlife.

Methods: 

The Michigan site of the Study of Women's Health Across the Nation conducted assessments of distance visual acuity at six consecutive, near-annual follow-up visits. At each visit, depressive symptoms (Center for Epidemiological Studies-Depression Scale) were assessed. VI was defined as mild (20/30-20/60) or moderate-severe (20/70 or worse). Multivariable logistic regression models using generalized estimating equations were used to assess the association of VI and reporting of depressive symptoms at the subsequent visit.

Results: 

At analytic baseline, the mean age of participants (N = 226) was 50.0 years (standard deviation = 2.6). More than half (53.5%) of women had mild VI and 8.0% had moderate-severe VI. Adjusting for age, preexisting depressive symptoms, race, education, economic strain, body mass index, and smoking, participants with mild and moderate-severe VI had 68% (95% C (0.97-2.90)) and 2.55-fold (95% CI 1.13-5.75) higher odds of reporting depressive symptoms at their subsequent study visit as compared with women without VI. Further adjustment for diabetes, hypertension, and osteoarthritis attenuated the estimates and the associations were no longer statistically significant.

Conclusion: 

VI was associated with increased odds of future depressive symptoms among mid-life women. Timely detection and appropriate correction of VI may be important to consider in maintaining the mental health status of midlife women.

© 2021 by The North American Menopause Society

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