Prevalence and Predictors of Depression Among Participants With Glaucoma in a Nationally Representative Population Sample

PURPOSE: To investigate the prevalence of and risk factors for depression among participants with glaucoma and the predictive value of glaucoma for depression. DESIGN: Cross-sectional study. METHODS: This study included 6760 participants in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2008, aged >= 40 years, who reported a presence or absence of glaucoma. Demographic and disease-related information was obtained by interview. Self-reported measures of vision were ascertained via items from the Visual Function Questionnaire (VFQ-25). Participants underwent visual acuity examination, fundus photography, and visual field testing with screening frequency-doubling technology (FDT N-30-5). The main outcome was presence of depression, as determined by a score >= 10 on the Patient Health Questionnaire-9 (PHQ-9). RESULTS: Prevalence of depression among participants with and without glaucoma was 10.9% (SEM 2.2%) and 6.9% (SEM 0.62%), respectively. While the presence of glaucoma was significantly associated with depression after adjustment for demographic factors (OR 1.80, 95% CI 1.16-2.79), this association was not significant after adjustment for self-reported general health condition (OR 1.35, 95% CI 0.822-2.23). Among participants with glaucoma, objective measures of glaucoma severity were not significant predictors for depression. However, several self-reported measures of visual function were significantly associated with depression. CONCLUSIONS: Glaucoma is a significant predictor of depression after adjustment for demographic factors and multiple comorbidities, but not after adjustment for self-reported general health condition. Among participants with glaucoma, self-reported measures of vision were significant risk factors for depression, whereas objective measures of vision were not. (Am J Ophthalmol 2012;154:436-444. (C) 2012 by Elsevier Inc. All rights reserved.)