Association between dry eye and depressive symptoms in an elderly Chinese population in Taiwan: the Shihpai Eye Study

Background Dry eye may impact quality of life and daily activities and depression is a widespread illness. Many studies showed the two diseases often coexist. However, studies were limited to retrospective chart review. This study aimed to investigate the association between dry eye and depressive symptoms in an older Asian population. Methods The Shihpai Eye Study was a community-based, cross-sectional survey of vision and eye diseases among noninstitutionalized subjects 65 years of age and older in Shihpai, Taipei, Taiwan. Residents fulfilling these criteria were randomly selected to be invited to participate in the study, which included a questionnaire and an eye examination conducted between July 1, 1999 and December 31, 2000. Results Of the 2045 subjects recruited, 1361 (66.6%) completed the examination. 8.8% (95% confidence interval (CI): 7.3-10.3%) of the participants were diagnosed to have depressive symptoms. Under multivariate analysis, depressive symptoms were significantly associated with frequent symptoms of dry eye (odds ratio (OR): 1.97, 95% CI: 1.36-2.92; p < 0.001). None of the dry eye signs was associated with depressive symptoms. For participants reporting frequent symptoms, tear-film break-up time <= 10 s (OR: 2.06, 95% CI: 1.38-3.05; p < 0.001), Schirmer test score <= 5 mm (OR: 2.01, 95% CI: 1.33-3.03; p < 0.001), and meibomian gland disease (OR: 1.99, 95% CI: 1.31-3.01; p = 0.001) were significantly related to depressive symptoms. Fluorescein staining of the cornea was not correlated to depressive symptoms in participants with dry eye symptoms. Conclusions Depressive symptoms are more highly correlated with dry eye symptoms than dry eye signs.