Depression and Quality of Life in Patients With Glaucoma: A Cross-sectional Analysis Using the Geriatric Depression Scale-15, Assessment of Function Related to Vision, and the Glaucoma Quality of Life-15

Purpose: To determine the prevalence of depression and its association with visual field impairment, quality of life, objective assessment of visual function, and glaucoma severity in elderly patients with glaucoma. Design: Cross-sectional study. Participants and Controls: One hundred sixty-five patients with mild (n = 60), moderate (n = 43), or severe (n = 28) glaucoma and 34 controls with ocular hypertension were enrolled. Severity was stratified according to the Nelson Glaucoma Severity Scale (based on the degree of binocular visual field loss). Groups were substratified according to age. Methods: Demographic information was collected via interviews; the Geriatric Depression Scale-15 and Glaucoma Quality of Life-15 (GQL-15) questionnaires were administered. Visual function was assessed by clinical examination and visual field testing. A subset of patients (n = 68) underwent objective assessment of function related to vision. Group differences were evaluated using analysis of variance; Kruskall-Wallis analysis of ranks was performed with significance set at P < 0.05. Age adjustment of P values was performed using analysis of covariance for parametric data and Kruskall-Wallis analysis on age-stratified nonparametric data. A binary univariate regression analysis modeled depression to suspected risk factors. Significant predictive variables were modeled in a multivariate regression analysis Results: Depression was more prevalent with increasing glaucoma severity, reaching statistical significance in patients aged 70 to 79 years (P < 0.02). Summary and subfactor GQL-15 scores reflected decreased quality of life with increasing glaucoma severity. Assessment of function related to vision scores indicated worsening visual function with increasing glaucoma severity. On multivariate regression analysis, depression status was correlated with age and GQL-15 summary score. Conclusions: Depression is more common in patients with increasing glaucoma severity (age, 70 to 79 y). In patients with glaucoma or ocular hypertension, age and GQL-15 summary score are independent risk factors for depression.