Wandered thought may turn away despairing in sight-incapacitated elderly individuals

For older people with age-related vision loss and at risk of developing depression, a type of treatment in which tailored options are only offered when necessary may help stave off both depression and anxiety, according to a recent European study.

Stepped-care delivery is aimed at long-term disease management that maximizes the effectiveness and efficiency of resources, the authors write in the BMJ. Patients start with lower intensity treatments and only progress to higher intensity interventions if they don't respond to the first efforts.

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"This way long-term disease management needs can be met - which is attractive for visually impaired older people who are likely to face further physical decline over time (eye diseases are often degenerative) that can lead to an increased risk of depression and anxiety - and the effectiveness and efficiency of resource allocation can be maximized," said lead author Hilde van der Aa of VU University Medical Center in Amsterdam, The Netherlands.


Visual impairment is associated with physical dysfunction, decreased mobility, limitations in daily life activities and increased dependency on others, van der Aa told Reuters Health by email.

"About one in three visually impaired older adults experience subclinical symptoms of depression and anxiety, which is about twice as high as the prevalence in normally sighted peers," she said.

Fifteen percent of visually intact older adults have symptoms of depression and around 2 percent have major depressive disorder, said Robin Casten of Thomas Jefferson University and the Jefferson Hospital for Neuroscience in Philadelphia, who was not part of the new study.