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Hwang G, Lee SH, Lee DY, Park C, Roh HW, Son SJ, Park RW. Age-related eye diseases and subsequent risk of mental disorders in older adults: A real-world multicenter study. J Affect Disord 2025; 375:306-315. [PMID: 39884366 DOI: 10.1016/j.jad.2025.01.128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Revised: 01/04/2025] [Accepted: 01/26/2025] [Indexed: 02/01/2025]
Abstract
BACKGROUND The relationship between age-related eye diseases and the subsequent risk of dementia and depressive disorders remains inconsistent. Furthermore, the effects on anxiety disorders and sleep disorders have been underexplored. This study aims to comprehensively examine the impact of age-related eye diseases on common mental disorders in older adults, thereby enhancing our understanding of the mental health implications in these conditions. METHODS The electronic health records of 1,522,036 patients aged over 60 from ten institutions in South Korea were analyzed. Patients with and without age-related eye diseases were identified, and 1:4 propensity score matching (PSM) was implemented. A 10-year longitudinal analysis was conducted using the Cox proportional hazards model to calculate the hazard ratios (HR). A meta-analysis was performed to combine the results from different institutions. Subgroup analyses were conducted to explore the impact of specific age-related eye diseases (cataract, glaucoma, age-related macular degeneration) on mental disorders. RESULTS A total of 41,637 patients with age-related eye disease were matched with 134,908 patients without such conditions. Patients with age-related eye disease showed a significantly higher risk of mental disorders (dementia, HR: 1.21 [95 % CI: 1.14-1.27]; depressive disorders, HR: 1.28 [95 % CI: 1.20-1.36]; anxiety disorders, HR: 1.31 [95 % CI: 1.22-1.41]; sleep disorders, HR: 1.29 [95 % CI: 1.22-1.37]). In subgroup analyses, each of the three age-related eye diseases was significantly associated with an increased risk of mental disorders. (cataract, HR: 1.25-1.33; glaucoma, HR: 1.15-1.49; age-related macular degeneration, HR: 1.18-1.37). CONCLUSION Age-related eye diseases increase the risk of developing mental disorders in older adults, highlighting the need for a multidisciplinary approach to patient care in these conditions.
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Affiliation(s)
- Gyubeom Hwang
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - So Hee Lee
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Dong Yun Lee
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - ChulHyoung Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyun Woong Roh
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sang Joon Son
- Department of Psychiatry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Rae Woong Park
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea.
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Niu T, Cao S, Wang X, Xian X, Luo C, Ma J. Depressive symptoms and its influencing factors of older people with cataracts in China: a national cross-sectional survey. Front Public Health 2025; 13:1504275. [PMID: 39944060 PMCID: PMC11813796 DOI: 10.3389/fpubh.2025.1504275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2024] [Accepted: 01/08/2025] [Indexed: 05/09/2025] Open
Abstract
Background Depressive symptoms are a common complication in patients with cataracts and may exacerbate cataract symptoms. Therefore, it is important to focus on depressive symptoms and their influencing factors in older people with cataracts. The purpose of this study was to investigate the prevalence rate of depressive symptoms and influencing factors in Chinese older people with cataracts. Methods Descriptive analyses were used to report the sociodemographic characteristics, lifestyle, health status, and depressive symptoms of old people with cataracts in China. The chi-square test was used to compare differences between subjects with different demographic characteristics. Binary logistic regression was used to analyze the factors that influenced the depressive symptoms of cataract patients. Meanwhile, a random forest model was developed in this study to rank the importance of the influencing factors. Results Three hundred and six (25.27%) of 1,211 cataract patients included in this study suffered from depressive symptoms. Logistic regression analysis suggested that poor economic situation (AOR = 3.162, 95%CI: 1.719-5.817), social participation (AOR = 1.530, 95%CI: 1.053-2.222), having hearing disorder (AOR = 1.445, 95%CI: 1.040-2.008), poor self-reported health status (AOR = 2.646, 95%CI: 1.705-4.106), poor life satisfaction (AOR = 3.586, 95%CI: 1.652-7.784) were risk factors for depressive symptoms in cataract patients and consumption of fresh fruits (AOR = 0.587, 95%CI: 0.369-0.933) was a protective factor for depressive symptoms in cataract patients. The results of the random forest showed that self-reported health status was the most important factor influencing depressive symptoms in cataract patients. The other factors, in order of importance, were life satisfaction, economic situation, fruits, hearing disorder, and social participation. Conclusion The results suggested that the development of depressive symptoms in cataract patients was influenced by various factors. Medical staff should monitor these influencing factors more closely when treating and caring for patients with cataracts.
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Affiliation(s)
- Tengfei Niu
- Department of Basic Courses, Chongqing Medical and Pharmaceutical College, Chongqing, China
| | - Shiwei Cao
- The Second Clinical College, Chongqing Medical University, Chongqing, China
| | - Xiaoyu Wang
- College of Paediatrics, Chongqing Medical University, Chongqing, China
| | - Xiaobing Xian
- Thirteenth People’s Hospital of Chongqing, Chongqing, China
| | - Chunyang Luo
- Department of Neurology, Chongqing General Hospital, Chongqing University, Chongqing, China
| | - Jingxi Ma
- Department of Neurology, Chongqing General Hospital, Chongqing University, Chongqing, China
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Saba J, Nessa Z, Islam S, Kaley A, Koly KN. "I don't care about my mental health because I have a physical disability": A qualitative study on the mental healthcare-seeking behaviours of people with disabilities in Bangladesh. Acta Psychol (Amst) 2024; 251:104624. [PMID: 39626462 DOI: 10.1016/j.actpsy.2024.104624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 10/27/2024] [Accepted: 11/27/2024] [Indexed: 12/16/2024] Open
Abstract
In Bangladesh, people living with disabilities are one of the most vulnerable groups, as they receive little or no assistance. They face numerous challenges regarding financial, social, and access to basic education and healthcare, which contribute to experiences of distress and mental health issues. However, there is limited research on the mental health needs of people with disabilities and the accessibility of mental health services in Bangladesh. This qualitative study addresses this gap by examining the mental healthcare-seeking behaviours of people with disabilities and challenges in care-seeking pathways and recommendations for devising an inclusive system in existing mental health services through key informant interviews and focus group discussions with 55 participants from four stakeholder groups. Findings highlight that limited mental health, literacy, stigma, and financial and logistical challenges, such as inaccessible transportation and distant facilities, hinder access to care. System-level barriers, including a lack of specialists and inadequate community-based services, further exacerbate the issue. Stakeholders recommended strengthening social support systems by providing disability identity cards, allowances, and access to inclusive education and employment opportunities. They also emphasized the need for awareness campaigns, better transportation options, and training for healthcare workers. Policymakers are urged to design culturally relevant needs-based interventions to improve mental healthcare pathways for people with disabilities while promoting multisectoral collaboration.
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Affiliation(s)
- Jobaida Saba
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh.
| | - Zinnatun Nessa
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh.
| | - Shahida Islam
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh.
| | - Alex Kaley
- School of Health and Social Care, University of Essex, Essex, United Kingdom.
| | - Kamrun Nahar Koly
- Health System and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Mohakhali, Dhaka 1212, Bangladesh.
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Shakya S, Silva SG, McConnell ES, McLaughlin SJ, Cary MP. Psychosocial stressors associated with frailty in community-dwelling older adults in the United States. J Am Geriatr Soc 2024; 72:1088-1099. [PMID: 38391046 DOI: 10.1111/jgs.18821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 01/14/2024] [Accepted: 01/21/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Frailty is multifactorial; however, psychosocial stressors contributing to frailty are poorly understood. This study aimed to examine whether gender, race/ ethnicity, and education are associated with differential exposure to psychosocial stressors, determine psychosocial stressors contributing to frailty, and explore the mediating psychosocial stressors pathway. METHODS This cross-sectional study involved 7679 community-dwelling older adults (≥65) from the Health and Retirement Study (2006 and 2008 waves). Psychosocial stressors such as loneliness, low subjective social status, financial strain, poor neighborhood cohesion, everyday discrimination, and traumatic life events were measured. Frailty was defined by the Fried phenotype measure. Multivariable logistic regressions were used to examine the association of gender, race/ethnicity, and education with psychosocial stressors, psychosocial stressors associated with frailty, and the mediating psychosocial stressors pathway. RESULTS Females experienced greater financial strain but lower discrimination (both p < 0.05). Older adults who identified as Hispanic, Black, and racially or ethnically minoritized experienced low subjective social status, high financial strain, low neighborhood cohesion, and high discrimination than their White counterparts (all p < 0.05). Those with lower education experienced high loneliness, low subjective social status, high financial strain, low neighborhood cohesion but lower traumatic life events (all p < 0.05). Psychosocial stressors: High loneliness, low subjective social status, high financial strain, and low neighborhood cohesion (all p < 0.05) independently increased the odds of frailty. The mediating pathway of psychosocial stressors was not significant. CONCLUSION: Disparities exist in exposure to psychosocial stressors associated with frailty. Multilevel interventions are needed to reduce the influence of psychosocial stressors on frailty.
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Affiliation(s)
- Shamatree Shakya
- College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Susan G Silva
- School of Nursing, Duke University, Durham, North Carolina, USA
| | - Eleanor S McConnell
- Department of Veterans Affairs Medical Center, Geriatric Research, Education and Clinical Center (GRECC), Durham, North Carolina, USA
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, Ohio, USA
| | - Michael P Cary
- School of Nursing, Duke University, Durham, North Carolina, USA
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Mulkutkar M, Damani M, Sawarkar S. Polymeric microneedles for the eye: An overview of advances and ocular applications for minimally invasive drug delivery. Eur J Pharm Biopharm 2024; 197:114209. [PMID: 38336234 DOI: 10.1016/j.ejpb.2024.114209] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/29/2024] [Accepted: 02/02/2024] [Indexed: 02/12/2024]
Abstract
Ocular drug delivery is challenging due to the presence of tissue barriers and clearance mechanisms. Most widely used topical formulations need frequent application because of poor permeability, short retention, and low bioavailability. Invasive intraocular injections and implants that deliver drugs at the target site are associated with infections, inflammation, and even vision loss post-use. These gaps can be addressed by a delivery platform that can efficiently deliver drug with minimal tissue damage. Microneedles were introduced as a delivery platform for overcoming dermal barriers with minimal tissue damage. After the successful clinical transition of microneedles in the transdermal drug delivery, they are now being extensively studied for ocular applications. The attributes of minimally invasive application and the capability to deliver a wide range of therapeutics make microneedles an attractive candidate for ocular drug delivery. The current manuscript provides a detailed overview of the recent advancements in the field of microneedles for ocular use. This paper reviews research focusing on polymeric microneedles and their pharmaceutical and biopharmaceutical properties. A brief discussion about their clinical translation and regulatory concerns is also covered. The multitude of research articles supports the fact that microneedles are a potential, minimally invasive drug delivery platform for ophthalmic use.
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Affiliation(s)
- Madhura Mulkutkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Mansi Damani
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India
| | - Sujata Sawarkar
- Department of Pharmaceutics, SVKM's Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, Mumbai, India.
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Hackett RA, Hunter MS, Jackson SE. The relationship between gender discrimination and wellbeing in middle-aged and older women. PLoS One 2024; 19:e0299381. [PMID: 38507365 PMCID: PMC10954130 DOI: 10.1371/journal.pone.0299381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/07/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Emerging evidence suggests that perceived gender discrimination negatively impacts mental wellbeing in young women. PURPOSE This study explored whether a similar relationship exists in middle-aged and older women. METHODS A total of 3081 women (aged ≥52 years) from the English Longitudinal Study of Ageing provided data on perceived gender discrimination in 2010/11. Depressive symptoms, loneliness, quality of life and life satisfaction were assessed in 2010/11 and in 2016/17. RESULTS Perceived gender discrimination was reported by 282 (9.2%) participants. Cross-sectionally, women who perceived gender discrimination reported more depressive symptoms (β = 0.34, 95% CI 0.11 to 0.57) and had higher loneliness scores (β = 0.14, 95% CI 0.08 to 0.20) than women who did not perceive gender discrimination. They also reported significantly lower quality of life (β = -2.50, 95% CI -3.49 to -1.51) and life satisfaction (β = -1.07, 95% CI -1.81 to -0.33). Prospectively, perceived gender discrimination was associated with greater loneliness scores (β = 0.08, 95% CI 0.02 to 0.14), as well as lower ratings of quality of life (β = -0.98, 95% CI -0.09 to -1.86), and life satisfaction (β = -1.04, 95% CI -0.34 to -1.74), independent of baseline values. CONCLUSIONS Middle-aged and older women who perceive gender discrimination report poorer mental wellbeing than those who do not perceive discrimination. Further, this type of discrimination may be predictive of declining mental wellbeing over time. These findings highlight the need for interventions to target gender-based discrimination to improve the wellbeing of women at mid- and older age.
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Affiliation(s)
- Ruth A. Hackett
- Institute of Psychiatry, Psychology and Neuroscience, Health Psychology Section, King’s College London, London, United Kingdom
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Myra S. Hunter
- Institute of Psychiatry, Psychology and Neuroscience, Health Psychology Section, King’s College London, London, United Kingdom
| | - Sarah E. Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
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Heinze N, Jones L, Bertiz F, Saunders E, Gomes RSM. How does the UK public think and feel about people with visual impairment: a review of existing evidence. Front Psychol 2024; 15:1359074. [PMID: 38515970 PMCID: PMC10954816 DOI: 10.3389/fpsyg.2024.1359074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Despite legislation to protect people with visual impairment (V.I.) from discrimination in the United Kingdom (UK), the latter continue to experience overt and covert negative behaviours. Perceived discrimination has been associated with an adverse impact on identity, health and well-being, while negative attitudes have been identified as the biggest barrier to participation in everyday life. This article provides a narrative review of existing evidence of how the UK public treats (behaviours), thinks (perceptions) and feels (attitudes) about people with V.I. Despite limitations, the findings suggest that there is a gap between the behaviours reported by people with V.I. and the attitudes expressed by members of the UK public. Social psychological theories are used to explore possible reasons for this gap, and ways in which it may be addressed. As such, the article provides an example of how social psychological theories can be used to address problems in an applied context.
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Affiliation(s)
| | - Lee Jones
- BRAVO VICTOR, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - Firuzé Bertiz
- Royal National Institute of Blind People, London, United Kingdom
| | - Emma Saunders
- Royal National Institute of Blind People, London, United Kingdom
| | - Renata S. M. Gomes
- BRAVO VICTOR, London, United Kingdom
- Northern Hub for Veterans and Military Families Research, Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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Wang Y, Liao J, Chen H, Tao L, Liu J. Association of perceived discrimination with the risk of depression among US older adults: A prospective population-based cohort study. Heliyon 2024; 10:e23843. [PMID: 38226276 PMCID: PMC10788503 DOI: 10.1016/j.heliyon.2023.e23843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/22/2023] [Accepted: 12/13/2023] [Indexed: 01/17/2024] Open
Abstract
AIMS Association between perceived discrimination and depression has been demonstrated in some sources of discrimination, such as age, sex, and race. However, the effects of perceived discrimination both in any domain and each domain on development of depression are still unclear. We aimed to estimate the association of any and each domain of perceived discrimination with the risk of depression among US older adults. METHODS We did a population-based cohort study using eight waves (from 2006 to 2020) of data from the Health and Retirement Study (HRS), a nationally representative study of US older adults aged 51 years and above. Perceived discrimination was measured by the shortened 5-item version of Williams' discrimination scale, including five domains (less courtesy, service setting, not smart, threatened or harassed, and medical setting). Depressive symptoms were assessed with shortened 8-item version of the Center for Epidemiological Depression scale (8-item CES-D). Cox proportional hazards models were used to estimate the crude and adjusted hazards ratio (HRs) and their 95 % confidence intervals (CIs) between perceived discrimination and risk of depression, after controlling for potential confounders. RESULTS A total of 18502 participants were included in our final analyses. 42.8 % of them had any perceived discrimination at baseline, and the most prevalent perceived discrimination was feeling less courtesy, which was observed in 5893 people (31.6 %). During a median of 9.8 years follow-up, 44.7 % of participants developed depression. The risk of depression was 46 % (adjusted HR: 1.46, 95 % CI: 1.39-1.52) higher among people with perceived discrimination than those without. The associations between perceived discrimination in each domain and risk of depression were all prominent. CONCLUSIONS Both any and each domain of perceived discrimination were associated with an increased risk of depression. Considering the high prevalence of perceived discrimination and the following poor health outcomes, our findings suggested the integrated measures of providing public education and diversified communication to reduce discrimination, as well as accessible emotional supports to prevent depression are urgently needed.
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Affiliation(s)
- Yaping Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Jiaojiao Liao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, No. 49, Huayuan North Road, Haidian District, Beijing, 100191, China
| | - Hongguang Chen
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
- National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), No.35, Xueyuan Road, Haidian District, Beijing, 100191, China
| | - Liyuan Tao
- Department of Epidemiology, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, No.38, Xueyuan Road, Haidian District, Beijing, 100191, China
- Institute for Global Health and Development, Peking University, No.5, Yiheyuan Road, Haidian District, Beijing, 100871, China
- Department of Global Health and Population, Harvard TH Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
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Li X, Liu L, Luo N, Sun Y, Bai R, Xu X, Liu L. Association of changes in self-reported vision and hearing impairments with depressive symptoms in middle-aged and older adults: Evidence from a nationwide longitudinal study in China. Arch Gerontol Geriatr 2024; 116:105131. [PMID: 37552924 DOI: 10.1016/j.archger.2023.105131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 07/14/2023] [Accepted: 07/15/2023] [Indexed: 08/10/2023]
Abstract
OBJECTIVE This study assessed the longitudinal relationship between changes in self-reported vision impairment (VI) and hearing impairment (HI), and depressive symptoms in adults aged ≥45 years. METHODS Data from the China Health and Retirement Longitudinal Study for 2015 and 2018 were used, with a sample size of 10,050. VI and HI were self-reported. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D10) was used to assess depressive symptoms. Total scores and clinically significant depressive symptoms (CES-D10 scores ≥ 10) were used as outcomes and analyzed using generalized estimating equations with identity link and logit link functions. RESULTS Of all changes in HI with good vision, only persistent HI was associated with higher CES-D10 scores (OR 95% CI: 1.09-3.30). Both new-onset and persistent VI with good hearing were associated with CES-D10 scores (OR 95% CI, new-onset: 1.70-3.52; persistent: 1.58-2.78) and clinically significant depressive symptoms (OR 95% CI, new-onset: 1.41-2.56; persistent: 1.36-2.27). Persistent dual sensory impairment (DSI) was associated with the highest CES-D10 scores (OR 95% CI: 3.63-5.97) and the highest risk of clinically significant depressive symptoms (OR 95% CI: 1.78-2.85). Those who self-reported improvements in vision and hearing still had higher CES-D10 scores (OR 95% CI: 1.35-2.83) and a higher risk of clinically significant depressive symptoms (OR 95% CI: 1.03-2.02) than those maintaining good vision and hearing. CONCLUSION Self-reported VI and DSI are closely associated with depressive symptoms. Because VI and DSI are modifiable, interventions for them could also prevent depressive symptoms.
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Affiliation(s)
- Xueying Li
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Libing Liu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Nansheng Luo
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Yu Sun
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Ru Bai
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China
| | - Xin Xu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang 110122, China.
| | - Li Liu
- Department of Social Medicine, School of Health Management, China Medical University, Shenyang 110004, China.
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Heinze N, Castle CL. Exploring mental well-being, the emotional impact of visual impairment and experiences of prejudice and discrimination among adults from minority ethnic communities in the UK. Front Public Health 2023; 11:1277341. [PMID: 37808983 PMCID: PMC10558210 DOI: 10.3389/fpubh.2023.1277341] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/08/2023] [Indexed: 10/10/2023] Open
Abstract
Background Visual impairment (V.I.) has been associated with a negative impact on mental health outcomes, including a process of grief among those who lose their sight. Older adults with V.I. who had experienced discrimination have been found to be at increased risk of depression, loneliness, poorer life satisfaction and poorer quality of life. Adults from minority ethnic communities (MEC) may be at increased risk of V.I. and yet, research on the experiences of MEC adults with V.I. remains limited. This article forms part of a series which explores issues and status among MEC adults living with V.I. in the UK. Methods A secondary analysis of V.I. Lives survey data was performed to explore mental well-being assessed by the short Warwick-Edinburgh Mental Well-being scale (SWEMWBS), the emotional impact of V.I., and prejudice and discrimination among a matched control sample of 77 MEC and 77 adults from white communities (WC). Participants were matched by age, gender, UK region and urban/rural setting. Subgroup analyses were also conducted for the two largest MEC subgroups, Asian (n = 46) and black participants (n = 22). Results There were few statistically significant differences between the groups. MEC participants were significantly more likely than WC participants to rate emotional support to come to terms with their V.I. as important and to feel optimistic about their V.I. but they were significantly less likely to agree that they were receiving the level of emotional support they needed to get on with their life. Within the MEC group, participants from Asian communities had significantly poorer mental well-being, and they were also significantly more likely to agree that the general public were often prejudiced against people with V.I. and less likely to feel optimistic about their V.I. than black participants. Conclusion Although there were few statistically significant differences, participants from Asian communities were more likely to report poor mental and emotional well-being, and experiences of discrimination, than black and white participants. In contrast, participants from black communities fared the same as, or in some cases better than, white participants. Future research will need to confirm these findings and explore reasons for these.
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Affiliation(s)
| | - Claire L. Castle
- BRAVO VICTOR, London, United Kingdom
- School of Music, Faculty of Arts, Humanities and Cultures, University of Leeds, Leeds, United Kingdom
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Somani N, Beukes E, Street A, Lindsay R, Smith L, Allen PM. Effectiveness of music-based interventions to address well-being in people with a vision impairment: a scoping review. BMJ Open 2023; 13:e067502. [PMID: 37709316 PMCID: PMC10503321 DOI: 10.1136/bmjopen-2022-067502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 08/18/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES The objectives of this review were to identify the types of music-based interventions and associated accessibility challenges for people who have visual impairment (VI) and their reported effects on psychological, physiological and social well-being. DESIGN A scoping review was developed according to the Joanna Briggs Institute methodology and reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist and guidelines. A narrative synthesis was conducted to map out the types of music-based interventions undertaken and to compare the therapeutic outcomes. The studies were evaluated according to the music reporting checklist. RESULTS In total 5082 records were identified, 69 full-text articles were screened and 13 studies were included. Eleven studies included younger children and teenagers, two focused on adults with acquired VI. Ten studies involved active music therapy strategies and three used passive music listening. Eleven of the studies focused on social outcomes and two reported mental health. Although the studies reported that music-based intervention strategies improved psychosocial well-being in people with a VI, conclusions could not be drawn as robust outcome measures were not generally used and only four of the studies included any statistical analysis. CONCLUSIONS Although potential was evident, details of intervention protocols and training requirements were not sufficiently reported and further, high-quality evidence-based studies are required.
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Affiliation(s)
- Nurbanu Somani
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Eldre Beukes
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Alexander Street
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Rosie Lindsay
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Peter M Allen
- Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
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12
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Hackett RA, Jackson SE, Corker E, Steptoe A. The role of stress and health behaviour in linking weight discrimination and health: a secondary data analysis in England. BMJ Open 2023; 13:e072043. [PMID: 37709322 PMCID: PMC10503332 DOI: 10.1136/bmjopen-2023-072043] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/29/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVE To examine the role of stress and health-risk behaviours in relationships between weight discrimination and health and well-being. DESIGN Secondary data analysis of an observational cohort study. SETTING The English Longitudinal Study of Ageing. PARTICIPANTS Data were from 4341 adults (≥50 years) with overweight/obesity. PRIMARY OUTCOME MEASURES We tested associations between perceived weight discrimination at baseline (2010/2011) and self-rated health, limiting long-standing illness, depressive symptoms, quality of life and life satisfaction over 4-year follow-up (2010/2011; 2014/2015). Potential mediation by stress exposure (hair cortisol) and health-risk behaviours (smoking, physical inactivity, alcohol consumption) was assessed. RESULTS Cross-sectionally, perceived weight discrimination was associated with higher odds of fair/poor self-rated health (OR=2.05 (95% CI 1.49 to 2.82)), limiting long-standing illness (OR=1.76 (95% CI 1.29 to 2.41)) and depressive symptoms (OR=2.01 (95% CI 1.41 to 2.85)) and lower quality of life (B=-5.82 (95% CI -7.01 to -4.62)) and life satisfaction (B=-2.36 (95% CI -3.25 to -1.47)). Prospectively, weight discrimination was associated with higher odds of fair/poor self-rated health (OR=1.63 (95% CI 1.10 to 2.40)) and depressive symptoms (OR=2.37 (95% CI 1.57 to 3.60)) adjusting for baseline status. Those who reported discrimination had higher hair cortisol concentrations (B=0.14 (95% CI 0.03 to 0.25)) and higher odds of physical inactivity (OR=1.90 (95% CI 1.18 to 3.05)). These variables did not significantly mediate associations between discrimination and health outcomes. CONCLUSIONS Weight discrimination is associated with poor health and well-being. While this discrimination is associated with stress exposure and physical inactivity, these variables explain little of the association between discrimination and poorer outcomes.
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Affiliation(s)
- Ruth A Hackett
- Health Psychology Section, Department of Psychology, King's College London, London, UK
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, UK
| | - Elizabeth Corker
- Clinical, Educational and Health Psychology, University College London, London, UK
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
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13
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Shakya S, Silva SG, McConnell ES, McLaughlin SJ, Cary MP. Does cumulative psychosocial stress explain frailty disparities in community-dwelling older adults? Arch Gerontol Geriatr 2023; 113:105055. [PMID: 37167754 DOI: 10.1016/j.archger.2023.105055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 04/20/2023] [Accepted: 05/02/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVE Frailty is a leading predictor of adverse outcomes in older adults. Although disparities in frailty are well-documented, it is unclear whether psychosocial stressors explain these disparities. This study aimed to examine the potential mediating role of psychosocial stress. METHODS This cross-sectional study included 7,679 community-dwelling older adults (≥ 65) from Health and Retirement Study in the US (2006 and 2008). We used six dichotomized psychosocial stressors: a) loneliness, b) discrimination, c) financial strain, d) low subjective status, e) poor neighborhood cohesion, and f) traumatic life events to compute cumulative psychosocial stress. The Fried frailty phenotype defined frailty based on three features: slowness, poor strength, weight loss, fatigue, and low physical activity. Multivariable regressions were used to examine the structural determinants (gender, education, race, and ethnicity) frailty relationship and test whether cumulative psychosocial stress has a mediating role. RESULTS The frailty prevalence was 22%. Females, Hispanics, Blacks, and those with less education had higher odds of frailty (p<.01). Race and ethnic minorities and non-college graduates experienced greater cumulative psychosocial stress relative to their White and college graduate counterparts (p<.05), respectively. Greater cumulative psychosocial stress was associated with increased odds of frailty (p < .001); however, it did not mediate the structural determinants and frailty relationship. CONCLUSION Contrary to expectations, cumulative psychosocial stress did not mediate the relationship between structural determinants and frailty. Rather, high cumulative psychosocial stress was independently associated with frailty. Further research should examine other psychosocial mediators to inform interventions to prevent/delay frailty.
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Affiliation(s)
| | | | - Eleanor S McConnell
- Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs Medical Center, Durham, NC, USA
| | - Sara J McLaughlin
- Department of Sociology and Gerontology, Miami University, Oxford, OH, USA
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14
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Tantirattanakulchai P, Hounnaklang N, Pongsachareonnont PF, Khambhiphant B, Win N, Tepjan S. Prevalence and Factors Associated with Suicidal Ideation Among Older People with Visual Impairments Attending an Eye Center During the COVID-19 Pandemic: A Hospital-Based Cross-Sectional Study. Clin Ophthalmol 2023; 17:917-930. [PMID: 36968286 PMCID: PMC10035352 DOI: 10.2147/opth.s403003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 03/16/2023] [Indexed: 03/29/2023] Open
Abstract
Purpose To evaluate the prevalence of suicidal ideation and associated factors among older people with visual impairments attending an eye center during the COVID-19 pandemic. Patients and Methods A total of 314 older people aged 60 and above with visual impairments who attended an eye center were included in this study. This was a hospital-based cross-sectional study conducted from February to July, 2022. Data were collected in person. Suicidal ideation was measured using the Columbia-Suicide Severity Rating Scale (C-SSRS). Multivariable logistic regression analysis was used to explore associations between related factors and suicidal ideation. Results Of 314 older people with visual impairments, the prevalence of suicidal ideation was 32.5%. Suicidal ideation was independently associated with diabetic retinopathy (adjusted odds ratio (AOR)=2.4, 95% confidence interval (CI): 1.0-5.8; p=0.038) and depression (AOR=6.3, 95% CI: 3.5-11.2; p<0.001). Conclusion This study found a relatively high prevalence of suicidal ideation among older people with visual impairments. There was also a significant association between depression and suicidal ideation among these individuals. Visual impairments can lead to negative émotions. This underscores the importance of addressing the mental health needs of older individuals with visual impairments, including suicide prevention efforts tailored to their needs. Ophthalmologists should be equipped with the skills necessary to identify the early signs of suicidal ideation and refer patients to mental healthcare specialists for appropriate treatment.
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Affiliation(s)
| | | | - Pear Ferreira Pongsachareonnont
- Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Bharkbhum Khambhiphant
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Nanda Win
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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15
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Nekolova J, Kremlacek J, Lukavsky J, Sikl R, Sin M, Langrova J, Szanyi J, Jiraskova N. The intraocular implant and visual rehabilitation improve the quality of life of elderly patients with geographic atrophy secondary to age-related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2023; 261:263-272. [PMID: 35982247 PMCID: PMC9388354 DOI: 10.1007/s00417-022-05803-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/27/2022] [Accepted: 08/05/2022] [Indexed: 01/19/2023] Open
Abstract
INTRODUCTION The objective of this prospective study was to evaluate the effects of intraocular macular lens implantation and visual rehabilitation on the quality of life of patients with geographic atrophy (GA) secondary to age-related macular degeneration (AMD). METHODS Patients with bilaterally decreased near vision (not better than 0.3 logMAR with the best correction), pseudophakia, were included in the project. The Scharioth macula lens (SML) was implanted into the patients' better-seeing eye. Intensive visual rehabilitation of the ability to perform nearby activities was performed for 20 consecutive postoperative days. All subjects were examined before and after SML implantation ophthalmologically. The National Eye Institute 25-Item Visual Function Questionnaire (NEI VFQ-25) was administered before and 6 months after surgery. RESULTS Twenty eligible patients with mean age 81 years (63 to 92 years) were included in the project: 7 males and 13 females. Nineteen of them completed the 6-month follow-up. Near uncorrected visual acuity was 1.321 ± 0.208 logMAR before SML implantation and improved to 0.547 ± 0.210 logMAR after 6 months (dz = - 2.846, p < 0.001, BF10 = 3.29E + 07). In the composite score of the NEI VFQ-25, there was an improvement in the general score and the specific domains related to the implantation. Participants reported fewer difficulties in performing near activities (dz = 0.91, p = 0.001, BF10 = 39.718) and upturns in mental health symptoms related to vision (dz = 0.62, p = .014, BF10 = 3.937). CONCLUSION SML implantation, followed by appropriate rehabilitation, improved near vision and increased the quality of life of visually handicapped patients with AMD in our project.
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Affiliation(s)
- Jana Nekolova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Jan Kremlacek
- Department of Biophysics, Faculty of Medicine, Charles University, Simkova 870, 50003 Hradec Kralove, Czech Republic
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jiri Lukavsky
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Radovan Sikl
- Institute of Psychology, Czech Academy of Sciences, Brno, Czech Republic
| | - Martin Sin
- Military University Hospital Prague, Department of Ophthalmology 1st Faculty of Medicine of Charles University and Military University Hospital Prague, Prague, Czech Republic
| | - Jana Langrova
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Jana Szanyi
- Department of Pathological Physiology, Faculty of Medicine, Charles University, Simkova 870, Hradec Kralove, 50003 Czech Republic
| | - Nada Jiraskova
- Department of Ophthalmology, University Hospital Hradec Kralove and Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
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16
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Tantirattanakulchai P, Hounnaklang N, Pongsachareonnont PF, Khambhiphant B, Hounnaklang S, Win N, Tepjan S. Impact of COVID-19 on Depressive Symptoms Among Patients with Low Vision and Blindness. Clin Ophthalmol 2023; 17:789-796. [PMID: 36919032 PMCID: PMC10008418 DOI: 10.2147/opth.s401714] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 03/03/2023] [Indexed: 03/10/2023] Open
Abstract
Background Disability is globally recognized as a key cause of depression. Likewise, the COVID-19 pandemic has significantly increased the vulnerability of patients with low vision to health and health-related issues, especially mental health. This study aimed to examine the association between the impact of COVID-19 and depressive symptoms in patients with low vision and blindness. Methods This cross-sectional study was conducted between February and July 2022 and involved face-to-face interviews. Patients with low vision and blindness diagnosed with depression were excluded. The following items were included in the questionnaire: sociodemographic information, Multi-Dimensional Scale of Perceived Social Support (MSPSS), the impact of COVID-19, and The Center for Epidemiological Studies-Depression (CES-D). Hierarchical linear regression analysis was used to examine the association between the impact of COVID-19 and depression. Results The prevalence of depression among patients with low vision and blindness was 43.0%. Three factors were associated with depressive symptoms: compliance with COVID-19 prevention strategies (β = 0.16, p<0.01), anxiety during COVID-19 (β = 0.24, p<0.001), and social support (β = -0.16, p<0.01). Conclusion The findings indicated that COVID-19 significantly increased depressive symptoms among patients with low vision and blindness. The psychological effects of the COVID-19 pandemic have been considered critical and emergent public health issues. Stakeholders, particularly public health organizations, need to urgently implement preventive and protective measures to help patients with physical and mental disabilities.
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Affiliation(s)
| | | | - Pear Ferreira Pongsachareonnont
- Center of Excellence in Retina, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Bharkbhum Khambhiphant
- Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Nanda Win
- College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand
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17
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Kumar P, Campanile J, Swenor BK, Varadaraj V. Stigma Among Older Adults with Age-Related Vision Impairments. JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS 2022. [DOI: 10.1177/0145482x221132844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction: Limited research has examined the experience and psychosocial effect of vision impairment in older adults. We examine the relationship between vision impairment and stigma using guided interviews among older adults with age-related eye disease. Methods: Thirty-six participants with vision impairment were recruited from glaucoma ( n = 18) (better eye visual fields mean deviations: >5 and <15 decibels) or retina ( n = 18) (better eye visual acuity: <20/40 and >20/400) clinics of the Johns Hopkins Wilmer Eye Institute between 2015 and 2020. Participants completed interviews to examine stigma surrounding age-related vision impairment. Interviews were transcribed and analyzed using directed content analysis. Results: Content analyses of interview transcripts revealed underlying stigma within our cohort. Starting with categories of (1) interpersonal relationships and (2) evolving self-perception, specific domains of stigma were realized in this study. Although both enacted (external) stigma and perceived stigma were acknowledged by a subset of participants, few endorsed internalized stigma. In the face of stigma, participants demonstrated notable resiliency in adapting to and living with age-related vision impairment, captured in an additional category of (3) behavioral adaptations. Discussion: In-depth interviews revealed that older adults with vision impairment confront specific domains of stigma, including enacted and perceived stigma. Features protective against internalized stigma included older age, community support, and assistive technologies. Implications for Practitioners: A recognition of the subtypes of stigma that older adults with age-related vision impairment face is necessary to tailor support and target interventions.
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Affiliation(s)
- Priyanka Kumar
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jessica Campanile
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
- The Johns Hopkins Disability Health Research Center, Baltimore, MD
- The Johns Hopkins School of Nursing, Baltimore, MD
| | - Bonnielin K. Swenor
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
- The Johns Hopkins Disability Health Research Center, Baltimore, MD
- The Johns Hopkins School of Nursing, Baltimore, MD
- The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Varshini Varadaraj
- Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD
- The Johns Hopkins Disability Health Research Center, Baltimore, MD
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18
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Amirova A, Rimes KA, Hackett RA. Perceived discrimination in middle-aged and older adults: Comparison between England and the United States. Front Public Health 2022; 10:975776. [PMID: 36438296 PMCID: PMC9685535 DOI: 10.3389/fpubh.2022.975776] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
Objectives This study examined differences in perceived discrimination across multiple characteristics in England and the United States (US), in middle- and older-aged adults. Methods Using data from the English Longitudinal Study of Aging (N = 8,671) and the US-based Health and Retirement Study (N = 7,927), we assessed cross-national differences in perceived discrimination attributed to disability, financial status, sex, race, sexual orientation, and weight. We also compared how perceived discrimination varied with socioeconomic position (SEP) based on wealth. Results Perceived discrimination due to financial status was more common in England (6.65%) than in the US (2.14%) adjusting for age, sex, and wealth [Odds Ratio (OR) = 1.09, 95% CI (1.07; 1.10)]. This affected people of low but not high SEP. Sexual orientation discrimination was more common in England [0.72 vs. 0.15%, OR = 4.61, 95% CI (2.48; 8.57)]. Sex-based perceived discrimination was more prevalent in the US (12.42%) than England (9.07%) adjusting for age and wealth [OR = 0.87, 95% CI (0.86; 0.89)]. Cross-national differences in sex discrimination did not vary with SEP. Racism was the most common type of perceived discrimination reported in both samples (England: 17.84%, US: 19.80%), with no significant cross-national differences after adjustment for sex. Discussion Perceived discrimination attributed to financial status and sexual orientation were more prevalent in England, while more women perceived sex discrimination in the US. This study suggests that country-specific and socioeconomic factors affect the prevalence of perceived discrimination. This may be relevant when targeting interventions aimed at reducing perceived discrimination.
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19
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Gori M, Bertonati G, Mazzoni E, Freddi E, Amadeo MB. The impact of COVID-19 on the everyday life of blind and sighted individuals. Front Psychol 2022; 13:897098. [PMID: 36389583 PMCID: PMC9650307 DOI: 10.3389/fpsyg.2022.897098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 09/27/2022] [Indexed: 12/01/2022] Open
Abstract
The COVID-19 pandemic caused unexpected and unavoidable changes in daily life worldwide. Governments and communities found ways to mitigate the impact of these changes, but many solutions were inaccessible to people with visual impairments. This work aimed to investigate how blind individuals subjectively experienced the restrictions and isolation caused by the COVID-19 pandemic. To this end, a group of twenty-seven blind and seventeen sighted people took part in a survey addressing how COVID-19 impacted life practically and psychologically, how it affected their daily habits, and how it changed their experiences of themselves and others. Results demonstrated that both sighted and blind individuals had a hard time adapting to the new situation. However, while sighted people struggled more with personal and social aspects, the frustration of the blind population derived mostly from more practical and logistical issues. Likely as consequences, results showed that blind people engaged more in their inner life and experienced fear and anger as main emotions. This study suggests that changes in life associated with COVID-19 have been subjectively experienced differently based on the presence or not of blindness, and that tailored future interventions should be considered to take care of the different needs of blind individuals.
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Affiliation(s)
- Monica Gori
- Unit for Visually Impaired People, Italian Institute of Technology, Genova, Italy
| | - Giorgia Bertonati
- Unit for Visually Impaired People, Italian Institute of Technology, Genova, Italy
- DIBRIS, Università degli studi di Genova, Genova, Italy
- *Correspondence: Giorgia Bertonati,
| | - Emanuela Mazzoni
- Unit for Visually Impaired People, Italian Institute of Technology, Genova, Italy
- PREPOS Studio Associato, Lucca, Italy
| | - Elisa Freddi
- Unit for Visually Impaired People, Italian Institute of Technology, Genova, Italy
| | - Maria Bianca Amadeo
- Unit for Visually Impaired People, Italian Institute of Technology, Genova, Italy
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20
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Badger AE, Samuel LT, Tegge AN, Metrey M, Perez MA, Tuttle JR, Apel PJ. Patients Who Undergo Rotator Cuff Repair Can Safely Return to Driving at 2 Weeks Postoperatively. J Bone Joint Surg Am 2022; 104:1639-1648. [PMID: 35866652 PMCID: PMC9655183 DOI: 10.2106/jbjs.21.01436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Evidence-based guidelines are lacking for return to driving following rotator cuff repair (RCR). As a result, surgeons are often overly conservative in their recommendations, placing potential undue burden on patients and their families. Therefore, the primary objective of this study was to formulate evidence-based return-to-driving guidelines. METHODS Thirty-two subjects planning to undergo primary RCR were enrolled. Driving fitness was assessed in a naturalistic setting with an instrumented vehicle on public streets with a safety monitor onboard. Driving kinematic measures and behavioral data were obtained from vehicle data and camera capture. Several driving tasks and maneuvers were evaluated, including parking, left and right turns, straightaways, yielding, highway merges, and U-turns. The total course length was 15 miles (24 km) and the course took 45 to 55 minutes to complete. The subjects' baseline drive was performed prior to RCR and postoperative drives occurred at 2, 4, 6, and 12 weeks after RCR. All drives consisted of identical routes, tasks, and maneuvers. Driving metrics were analyzed for differences between baseline and postoperative drives, including differences in gravitational force equivalents (g). RESULTS Twenty-seven subjects (mean age, 58.6 years [range, 43 to 68 years]) completed all 5 drives. Of the 13 analyzed kinematic metrics measured from 14 of 17 driving events, all exhibited noninferiority across all postoperative drives (2 to 12 weeks) after RCR compared with baseline. Beginning at postoperative week 2, subjects generally braked less aggressively, steered more smoothly, and drove more stably. Kinematic metrics during the performance of specific maneuver types also showed noninferiority when compared with baseline. Of note, subjects drove more smoothly on highway merges starting at postoperative week 2 (minimum longitudinal acceleration, -0.35 g [95% confidence interval (CI), -0.050 to -0.019 g]; standard deviation of longitudinal acceleration, 0.008 g [95% CI, 0.003 to 0.013 g]), but exhibited more aggressive driving and acceleration on highway merges at postoperative week 12 (maximum absolute yaw, -0.8°/sec [95% CI, -1.2°/sec to -0.4°/sec]). CONCLUSIONS Patients showed no clinically important negative impact on driving fitness as early as 2 weeks after RCR. Adaptive behaviors were present both preoperatively and postoperatively. LEVEL OF EVIDENCE Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ariel E Badger
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia
| | - Linsen T Samuel
- Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics and Neurosciences, Roanoke, Virginia
| | - Allison N Tegge
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia
- Department of Statistics, Virginia Tech, Blacksburg, Virginia
| | - Mariette Metrey
- Virginia Tech Transportation Institute, Blacksburg, Virginia
| | - Miguel A Perez
- Virginia Tech Transportation Institute, Blacksburg, Virginia
| | - John R Tuttle
- Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics and Neurosciences, Roanoke, Virginia
| | - Peter J Apel
- Virginia Tech Carilion School of Medicine, Roanoke, Virginia
- Department of Orthopaedic Surgery, Carilion Clinic Institute for Orthopaedics and Neurosciences, Roanoke, Virginia
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21
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Zhao X, Liu W, Lu B, Zhu X, Zhou M, Sun X. Visual impairment and depression in China: a 7-year follow-up study from national longitudinal surveys. BMJ Open 2022; 12:e055563. [PMID: 35477885 PMCID: PMC9047878 DOI: 10.1136/bmjopen-2021-055563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To explore the longitudinal association between visual impairment (VI) and depression among adults 45 years and older in China based on a nationally representative follow-up dataset. SETTING Participants in China from the China Health and Retirement Longitudinal Study were included. PARTICIPANTS A total of 6748 participants from two waves of the China Health and Retirement Longitudinal Study 2011-2018 were included for analysis by age group. PRIMARY AND SECONDARY OUTCOME MEASURES VI and depression were defined by self-diagnosis and the Center for Epidemiological Studies Depression Scale-10, respectively. Lagged dependent variable regression models with ordinary least squares estimation were used to evaluate the association between VI and depression. Age was divided into three groups, that is, 45-54, 55-64, and 65 years and older, to explore the relationship between VI and depression in different age groups. RESULTS In our study sample, VI remarkably predicted an increase in depressive scores. The magnitude of depressive scores increased among those with VI points greater than 3.517 (β=3.517; 95% CI=2.697 to 4.331) points than those without VI in the 7-year follow-up. Significant relationships were also found between VI and depression in the three age groups in the sensitivity analysis. CONCLUSION VI was associated with an increase in depression scores over a 7-year period. Female respondents, low educational attainment and high alcohol intake significantly predicted an increase in depressive status.
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Affiliation(s)
- Xiaohuan Zhao
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Wenjia Liu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Bing Lu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xinyue Zhu
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Minwen Zhou
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital (Shanghai First People's Hospital), Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Fundus Diseases, Shanghai, China
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22
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Scott W, Jackson SE, Hackett RA. Perceived discrimination, health, and well-being among adults with and without pain: a prospective study. Pain 2022; 163:258-266. [PMID: 35029597 DOI: 10.1097/j.pain.0000000000002368] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/12/2021] [Indexed: 01/07/2023]
Abstract
ABSTRACT Discrimination negatively influences health and well-being in the general population, but its impact on people with pain is unclear. This study assessed discrimination, health, and well-being in people with and without pain. Data were from 5871 participants from the English Longitudinal Study of Ageing. Experiences of discrimination were reported in 2010 to 2011. Pain, self-rated health, depressive symptoms, quality of life, life satisfaction, and loneliness were assessed in 2010 to 2011 and 2016 to 2017. A quarter (26%, n = 1524) of the sample reported pain at baseline. Participants with pain were more likely to report discrimination than those without pain (odds ratio [OR] = 1.28, 95% confidence interval [CI] 1.13-1.46). Cross-sectionally, those with pain who perceived discrimination had poorer self-rated health (OR = 1.28, 95% CI 1.02-1.61), greater depressive symptoms (OR = 1.90, 95% CI 1.48-2.45), were more likely to be lonely (β = 0.21, 95% CI 0.15-0.26), and had lower quality of life (β = -4.01, 95% CI -4.88 to -3.14), and life satisfaction (β = -1.75, 95% CI -2.45 to -1.06) than those with pain who did not perceive discrimination. Prospectively, discrimination in those with pain was associated with greater depression (OR = 1.67, 95% CI 1.19-2.34) and loneliness (β = 0.11, 95% CI 0.05-0.17), adjusting for baseline values. In those without pain in 2010 to 2011, discrimination predicted pain in 2016 to 2017, controlling for covariates (OR = 1.29, 95% CI 1.06-1.56). People with pain are more likely to report discrimination than those without pain, and this experience is associated with increased depression and loneliness. Discrimination was predictive of incident pain in pain-free adults. These findings highlight the need to tackle discrimination to improve well-being in those with pain and to potentially reduce the risk of pain onset.
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Affiliation(s)
- Whitney Scott
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
- INPUT Pain Management Unit, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom
| | - Sarah E Jackson
- Department of Behavioural Science and Health, University College London, London, United Kingdom
| | - Ruth A Hackett
- Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Bonsaksen T, Brunes A, Heir T. Post-Traumatic Stress Disorder in People with Visual Impairment Compared with the General Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020619. [PMID: 35055443 PMCID: PMC8775682 DOI: 10.3390/ijerph19020619] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 11/27/2022]
Abstract
Background: People with a visual impairment appear to have an increased risk of experiencing potentially traumatizing life events and possibly also subsequently developing post-traumatic stress disorder (PTSD). This study investigated the point prevalence of PTSD in people with a visual impairment compared with the general population of Norway and examined factors associated with PTSD among people with a visual impairment. Methods: A telephone-based survey was administered to a probability sample of 1216 adults with a visual impairment. Of these, 736 (61% response rate) participated. A probability sample from the general population served as a reference (n = 1792, 36% response rate). PTSD was measured with the PTSD Checklist for the DSM-5 (PCL-5), based on the currently most bothersome event reported from the Life Events Checklist for DSM-5 (LEC-5). We used the DSM-5 diagnostic guidelines to categorize participants as fulfilling the PTSD symptom criteria or not. Results: The prevalence of PTSD was higher among people with a visual impairment than in the general population, both for men (9.0% vs. 3.8%) and women (13.9% vs. 8.5%). The prevalence rates of PTSD from the illness or injury that had caused the vision loss (men 3.9%, women 2.2%) accounted for a considerable part of the difference between the populations. For women, PTSD related to sexual assaults also contributed significantly to a higher PTSD prevalence in the visually impaired versus the general population (5.2% vs. 2.2%), while for men there were no other event categories which resulted in significant differences. Among people with a visual impairment, the higher risk of PTSD was associated with lower age, female gender, having acquired the vision loss, and having other impairments in addition to the vision loss. Conclusion: The higher prevalence of PTSD in people with a visual impairment suggests that vulnerability to mental health problems is associated with serious life events. The higher incidence than in the general population is partly due to the illness or injury that had led to the vision loss and partly due to people with vision loss appearing to be more vulnerable through exposure to other types of potentially traumatizing events, such as sexual abuse.
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Affiliation(s)
- Tore Bonsaksen
- Department of Health and Nursing Science, Faculty of Social and Health Studies, Inland Norway University of Applied Sciences, 2418 Elverum, Norway
- Department of Health, Faculty of Health Studies, VID Specialized University, 4306 Sandnes, Norway
- Correspondence:
| | - Audun Brunes
- Section for Trauma, Catastrophes and Forced Migration-Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway; (A.B.); (T.H.)
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration-Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, 0484 Oslo, Norway; (A.B.); (T.H.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0372 Oslo, Norway
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Sun W, Matsuoka T, Imai A, Oya N, Narumoto J. Effects of Hearing Impairment, Quality of Life and Pain on Depressive Symptoms in Elderly People: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212265. [PMID: 34832020 PMCID: PMC8620215 DOI: 10.3390/ijerph182212265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/18/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022]
Abstract
Reduction of the incidence of depression and improvement of quality of life (QOL) of elderly people have become important subjects. Various factors are related to depressive symptoms in elderly people, and sensory impairment is a key to health, QOL, and depressive symptoms. In this cross-sectional study, a visual acuity test and audiometry were used to examine the relationships of visual and hearing impairment and other factors with depressive symptoms in elderly people. A group of 490 community-dwelling people aged over 65 years old underwent vision and hearing tests, the Center for Epidemiologic Studies Depression Scale (CES-D), Mini-Mental State Examination (MMSE), and questionnaires on social isolation, QOL, and physical condition. Logistic regression analysis was used to examine factors affecting CES-D. Multivariate logistic regression analysis indicated that hearing impairment, pain score, and satisfaction with human relationships and activities of daily living (ADL) were independent predictors of CES-D scores. Satisfaction with human relationships and ADL can reduce depressive symptoms in elderly people. Hearing impairment, pain, and social contact are also important. Therefore, improvement of social networks, interpersonal relationships, ADL, and hearing impairment may be effective in improving these symptoms in elderly people.
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25
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Consequences of Perceived Personal and Group Discrimination against People with Hearing and Visual Impairments. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179064. [PMID: 34501653 PMCID: PMC8430579 DOI: 10.3390/ijerph18179064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/21/2021] [Accepted: 08/25/2021] [Indexed: 11/17/2022]
Abstract
The main objective of this study was to examine the consequences of perceived discrimination in people with hearing and visual impairments. Using path analysis, we attempted to validate a multigroup model in which perceived personal discrimination is associated with internalization of stigma, which, in turn, is negatively related to self-esteem; conversely, perceived discrimination against the in-group contributes to enhanced group identification, which promotes the intention to engage in collective action, which, in turn, has beneficial effects on self-esteem. The sample consisted of a total of 200 Spanish-speaking participants, of whom 104 had hearing impairments and 96 had visual impairments. The results showed that the proposed multigroup model fit the data well. For both groups, internalized stigma played a mediating role in the relationship between perceived personal discrimination and self-esteem. However, the pathway from group discrimination to self-esteem was not as clearly supported by the data. The results are interpreted from a psychosocial perspective and may contribute to design interventions aimed at improving the well-being of people with hearing and visual impairments.
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26
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Leveziel N, Marillet S, Braithwaite T, Peto T, Ingrand P, Pardhan S, Bron AM, Jonas JB, Resnikoff S, Little J, Bourne RR. Self-reported visual difficulties in Europe and related factors: a European population-based cross-sectional survey. Acta Ophthalmol 2021; 99:559-568. [PMID: 33029925 PMCID: PMC8451874 DOI: 10.1111/aos.14643] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 04/15/2020] [Accepted: 09/13/2020] [Indexed: 01/08/2023]
Abstract
PURPOSE There is a relative paucity of self-reported vision problems data in European countries. METHODS In this context, we investigated self-reported vision problems through European Health Interview Survey 2, a cross-sectional European population survey based on a standardized questionnaire including 147 medical, demographic and socioeconomic variables applied to non-institutionalized individuals aged 15 years or more in 28 European countries, in addition to Iceland and Norway. RESULTS The survey included 311 386 individuals (54.18% women), with overall crude prevalence of self-reported vision problems of 2.07% [95% CI; 2.01-2.14]. Among them, 1.70 % [1.61-1.78] of men, 2.41% [2.31-2.51] of women and 4.71% [4.53-4.89] of individuals aged 60 or more reported to have a lot of vision problems or to be not able to see. The frequency of self-reported vision problems was the highest in Eastern European countries with values of 2.43% [2.30-2.56]. In multivariate analyses, limiting long-standing illness, depression, daily smoking, lack of physical activity, lower educational level and social isolation were associated with self-reported vision problems with ORs of 2.66 [2.42-2.92], 2.16 [2.01-2.32], 1.11 [1.01-1.23], 1.31 [1.21-1.42], 1.29 [1.19-1.40] and 1.45 [1.26-1.67], respectively, while higher income was associated with less self-reported vision problems with OR of 0.80 [0.73-0.86]. CONCLUSIONS This study demonstrated inequalities in terms of prevalence of self-reported vision problems in Europe, with higher prevalence in Eastern European countries and among women and older individuals.
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Affiliation(s)
- Nicolas Leveziel
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
- CHU Poitiers Poitiers France
- CIC 1402 Poitiers France
- INSERM 1084 Poitiers France
- University of Poitiers Poitiers France
| | | | - Tasanee Braithwaite
- Centre for Patient Reported Outcomes Research and NIHR Birmingham Biomedical Research Centre University of Birmingham Birmingham UK
- Moorfields Eye Hospital London UK
| | - Tunde Peto
- Institute of Clinical Sciences Building A Queen's University Belfast Belfast UK
| | - Pierre Ingrand
- CHU Poitiers Poitiers France
- CIC 1402 Poitiers France
- Epidemiology and biostatistics department Faculty of Medicine University of Poitiers Poitiers France
| | - Shahina Pardhan
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
| | - Alain M. Bron
- Department of Ophthalmology University Hospital Dijon France
- Eye and Nutrition Research Group Bourgogne Franche‐Comté University Dijon France
| | - Jost B. Jonas
- Department of Ophthalmology Medical Faculty Mannheim Heidelberg University Mannheim Germany
| | - Serge Resnikoff
- Brien Holden Vision Institute and SOVSUniversity of New South Wales Sydney NSW Australia
| | - Julie‐Anne Little
- Centre for Optometry & Vision Science Biomedical Sciences Ulster University Coleraine UK
| | - Rupert R.A. Bourne
- Vision & Eye Research Institute Anglia Ruskin University Cambridge UK
- Cambridge Eye Research Centre Department of Ophthalmology Cambridge University Hospitals Cambridge UK
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27
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Shakarchi AF, Assi L, Ehrlich JR, Deal JA, Reed NS, Swenor BK. Dual Sensory Impairment and Perceived Everyday Discrimination in the United States. JAMA Ophthalmol 2021; 138:1227-1233. [PMID: 33034632 DOI: 10.1001/jamaophthalmol.2020.3982] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Perceived everyday discrimination is a psychosocial stressor linked to adverse health outcomes, including mortality. Objective To assess the association of vision impairment (VI), hearing impairment (HI), and dual sensory impairments (DSI) with everyday discrimination. Design, Setting, and Participants Cross-sectional analysis of the Health and Retirement Study 2006 and 2008 surveys, a US population-based survey that included noninstitutionalized adults 51 years and older. Analyses were weighted to account for complex sample design and differential nonresponse. Data were analyzed between October 2019 and November 2019. Exposures Participants rated their vision and hearing, using eyeglasses and/or hearing aids if applicable, on a Likert scale (poor, fair, good, very good, and excellent). Sensory impairment was defined as poor or fair ability in the relevant modality, and sensory impairment was categorized as neither sensory impairment (NSI), VI alone, HI alone, and DSI. Main Outcomes and Measures Perceived everyday discrimination was measured on the validated 5-question Williams scale (range 0 to 5). Linear regression models estimated differences in discrimination scores by sensory categories, adjusting for age, sex, race, ethnicity, non-US birth, body mass index, relationship status, net household wealth, and number of chronic diseases (among diabetes, hypertension, heart disease, stroke, lung disease, nonskin cancer, and arthritis). Results The sample included 13 092 individuals. After weighting the sample to be representative of the US population, 11.7% had VI alone, 13.1% HI alone, and 7.9% DSI. In the fully adjusted model, participants with VI alone (β [change in discrimination score], 0.07; 95% CI, 0.02-0.13), HI alone (β = 0.07; 95% CI, 0.02-0.11), and DSI (β = 0.23; 95% CI, 0.16-0.29) perceived greater discrimination compared with participants with NSI. The DSI group perceived greater discrimination than VI alone or HI alone. Conclusions and Relevance Older adults with VI or HI in the United States perceive greater everyday discrimination than older adults with NSI, and those with DSI perceive even more discrimination than those with either VI or HI alone. These results provide insight into the social impact of sensory loss and highlight a need to identify and address reasons for discrimination toward older adults with VI and HI.
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Affiliation(s)
- Ahmed F Shakarchi
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lama Assi
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Joshua R Ehrlich
- Center for Eye Policy and Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor
| | - Jennifer A Deal
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Nicholas S Reed
- Cochlear Center for Hearing and Public Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Bonnielin K Swenor
- Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
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28
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Kong L, Gao Z, Xu N, Shao S, Ma H, He Q, Zhang D, Xu H, Qu H. The relation between self-stigma and loneliness in visually impaired college students: Self-acceptance as mediator. Disabil Health J 2020; 14:101054. [PMID: 33358607 DOI: 10.1016/j.dhjo.2020.101054] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/15/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Loneliness, a negative emotion that is common in college students, may cause psychological disorders and behavioral issues. Particularly vulnerable are visually impaired college students, who are at an increased risk of loneliness. OBJECTIVES This study was aimed at explaining the current situation of loneliness among visually impaired college students as well as its influencing factors and exploring the intermediary role of self-acceptance between self-stigma and loneliness. METHOD Seventy-eight college students with visual impairment completed a series of self-report questionnaires, including the Self-Stigma of Disabled Scale (SSDS), the Self-Acceptance Questionnaire (SAQ), and the University of California-Los Angeles (UCLA) Loneliness Scale. Mediation analyses were conducted using PROCESS in SPSS. RESULTS Participants' mean loneliness score was 44.97 ± 9.35. Two survey factors were significantly associated with loneliness: visual impairment status and relationship with parents (p < 0.05). When controlling for extent of visual damage and relationship with parents, self-stigma showed a significant predictive effect on loneliness (B = 0.37, t = 4.1023, p < 0.01). CONCLUSIONS In China, visually impaired students suffer from a high level of loneliness, and self-acceptance plays a central role in connecting their self-stigma and loneliness.
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Affiliation(s)
- Lingling Kong
- Department of Psychology, Medical Humanities Research Center, Binzhou Medical University, Yantai, 264003, China.
| | - Zheng Gao
- Department of Psychology, Medical Humanities Research Center, Binzhou Medical University, Yantai, 264003, China.
| | - Na Xu
- Department of Psychology, Medical Humanities Research Center, Binzhou Medical University, Yantai, 264003, China.
| | - Shuhong Shao
- Department of Psychology, Medical Humanities Research Center, Binzhou Medical University, Yantai, 264003, China.
| | - Huiying Ma
- School of Special Education, Binzhou Medical University, Yantai, 264003, China.
| | - Qingxia He
- School of Special Education, Binzhou Medical University, Yantai, 264003, China.
| | - Dehai Zhang
- Human Resources Department, Binzhou Medical University, Yantai, 264003, China.
| | - Honghong Xu
- Medical Psychology Department, Peking University Health Science Center, Beijing, China.
| | - Haiying Qu
- Department of Psychology, Medical Humanities Research Center, Binzhou Medical University, Yantai, 264003, China.
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Brunes A, Heir T. Visual impairment and depression: Age-specific prevalence, associations with vision loss, and relation to life satisfaction. World J Psychiatry 2020; 10:139-149. [PMID: 32742947 PMCID: PMC7360524 DOI: 10.5498/wjp.v10.i6.139] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To our knowledge, no study has obtained specific estimates of depression for young and middle-aged adults with visual impairment (VI). As estimates of depression varies across age groups in the general population, it is of interest to examine whether the same applies to adults with low vision or blindness.
AIM To estimate depression prevalence and its association with VI-related characteristics and life satisfaction in adults with VI.
METHODS A telephone-based cross-sectional survey was conducted between January and May 2017 in an age-stratified sample of adults who were members of the Norwegian Association of the Blind and Partially Sighted. Participants were asked questions about their sociodemographic characteristics, VI characteristics, and life satisfaction. Depression was measured with the Patient Health Questionnaire. The diagnostic scoring algorithm was used to calculate the point prevalence of depression (i.e., major depression and other depressive disorders) across categories of gender and age (years: 18-35, 36-50, 51-65, ≥ 66). The associations were estimated using regression models.
RESULTS Overall, 736 adults participated in the study (response rate: 61%). The prevalence estimates of depression varied across different age groups, ranging from 11.1%-22.8% in women and 9.4%-16.5% in men, with the highest rates for the two youngest age groups. Results from the multivariable models including sociodemographic and VI-related variables showed that losing vision late in life [Prevalence ratio (PR), 1.76, 95%CI: 1.11, 2.79] and having other impairments (PR: 1.88, 95%CI: 1.32, 2.67) were associated with higher rates of depression, whereas older age was associated with lower rates (PR: 0.83, 95%CI: 0.74, 0.93). Additionally, participants who were depressed had lower life satisfaction than those who were not depressed (adjusted β: -2.36, 95%CI: -2.75, -1.98).
CONCLUSION Our findings suggest that depression in adults with VI, and especially among young and middle-aged adults, warrants greater attention by user organisations, clinicians, and healthcare authorities.
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Affiliation(s)
- Audun Brunes
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo NO-0484, Norway
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo NO-0484, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, NO-0315, Norway
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Brunes A, Heir T. Social interactions, experiences with adverse life events and depressive symptoms in individuals with visual impairment: a cross-sectional study. BMC Psychiatry 2020; 20:224. [PMID: 32398122 PMCID: PMC7216619 DOI: 10.1186/s12888-020-02652-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 05/04/2020] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Knowledge about the high rates of depression in people with visual impairment (VI) remains unclear. The study aimed to examine whether depressive symptoms in people with VI were associated with social isolation, perceived social support and lifetime exposure to bullying, physical abuse or sexual abuse. METHODS An anonymous telephone survey was conducted from January to May 2017 in an age-stratified sample of adults with VI who were members of the Norwegian Association of the Blind and Partially Sighted. Participants were asked questions about social isolation, perceived social support, and past experiences with bullying and abuse. Depressive symptoms were measured by the nine-item Patient Health Questionnaire (PHQ-9). We calculated unadjusted and full-adjusted exponentiated beta-values (Exp(β)) and corresponding 95% confidence intervals (CIs) using generalized linear models. RESULTS Overall, 736 (61%) adults participated in the study. The mean depression scores were 5.24 (SD: 5.3, range: 0-27), 4.61 for men and 5.77 for women. Results from the full-adjusted model showed higher levels of depressive symptoms among participants who reported social isolation (Exp(β): 1.89, 95% CI: 1.63-2.20), lower levels of perceived social support (Exp(β): 1.55, 95% CI: 1.31-1.83), and past experiences of abuse (Exp(β): 1.41, 95% CI: 1.17-1.70). The strength of the associations between past exposure to bullying or abuse and depressive symptoms was similar for those with low and high levels of support. CONCLUSION Social isolation, perceived support and experiences of adverse events appear to be independently associated with depressive symptoms. Thus, social integration may be appropriate for the promotion of mental health among people with VI.
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Affiliation(s)
- Audun Brunes
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, PB 181 Nydalen, Oslo, NO-0409 Norway
| | - Trond Heir
- Section for Trauma, Catastrophes and Forced Migration - Adults and Elderly, Norwegian Centre for Violence and Traumatic Stress Studies, PB 181 Nydalen, Oslo, NO-0409 Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, PB 1171 Blindern, Oslo, NO-0318 Norway
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