ImportanceVision impairment and psychosocial function, including symptoms of depression and anxiety and social isolation, are a major cause of morbidity in the US. However, there is a lack of nationally representative studies assessing associations between both objective and subjective vision impairment with psychosocial function following the COVID-19 pandemic.ObjectiveTo provide updated national estimates on the associations of vision impairment with depressive and anxiety symptoms and social isolation in US adults 65 years and older.Design, Setting, and ParticipantsThis was a cross-sectional analysis of the National Health and Aging Trends Study round 9 (2019) and 11 (2021), a nationally representative sample of Medicare beneficiaries aged 65 years and older. Binocular distance visual acuity, near visual acuity, and contrast sensitivity were tested. Objectively measured vision impairment was defined as having vision impairment in either distance visual acuity (worse than 20/40), near visual acuity (worse than 20/40), or contrast sensitivity (worse than 1.55 logCS). Self-reported vision impairment was defined based on participants’ report on their vision status. Data were analyzed in May 2023.Main Outcomes and MeasuresDepressive and anxiety symptoms assessed via the Patient Health Questionnaire. Social isolation was defined based on living arrangement, communication frequency, and activity participation responses.ResultsAmong 2822 community-dwelling adults sampled from a population of 26 182 090, the mean (SD) age was 78.5 (5.6) years; 1605 individuals (54.7%) were female; 1077 (32.3%) had objectively measured vision impairment, and 203 (6.4%) had self-reported vision impairment. In adjusted models, all outcomes were significantly associated with objectively measured vision impairment, including depressive symptoms (odds ratio [OR], 1.81; 95% CI, 1.26-2.58), anxiety symptoms (OR, 1.74; 95% CI, 1.13-2.67), and severe social isolation (OR, 2.01; 95% CI, 1.05-3.87). Similarly, depressive symptoms (OR, 2.37; 95% CI, 1.44-3.88) and anxiety symptoms (OR, 2.10; 95% CI, 1.09-4.05) but not severe social isolation symptoms (OR, 2.07; 95% CI, 0.78-5.49) were significantly associated with self-reported vision impairment.Conclusions and RelevanceIn this study, vision impairment was associated with several psychosocial outcomes, including symptoms of depression and anxiety and social isolation. These findings provide evidence to support prioritizing research aimed at enhancing the health and inclusion of people with vision impairment.

中文翻译：

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美国成年人的视力障碍和心理社会功能

重要性视力障碍和心理社会功能，包括抑郁、焦虑和社会孤立的症状，是美国发病的主要原因。然而，缺乏全国代表性的研究来评估 COVID-19 大流行后客观和主观视力损伤与心理社会功能之间的关联。目的提供关于美国视力损伤与抑郁和焦虑症状以及社会隔离之间关系的最新国家估计65 岁及以上成年人。设计、设置和参与者这是对第 9 轮（2019 年）和第 11 轮（2021 年）国家健康和老龄化趋势研究的横断面分析，该研究是 65 岁及以上 Medicare 受益人的全国代表性样本。测试双眼远视力、近视力和对比敏感度。客观测量的视力损害被定义为远视力（低于20/40）、近视力（低于20/40）或对比敏感度（低于1.55 logCS）的视力障碍。自我报告的视力障碍是根据参与者对其视力状况的报告来定义的。数据于 2023 年 5 月进行分析。主要结果和措施通过患者健康问卷评估抑郁和焦虑症状。社会隔离是根据居住安排、交流频率和活动参与反应来定义的。结果在从 26 182 090 名人口中抽取的 2822 名社区居住成年人中，平均 (SD) 年龄为 78.5 (5.6) 岁；1605 人（54.7%）为女性；1077 人（32.3%）有客观测量的视力障碍，203 人（6.4%）有自我报告的视力障碍。在调整后的模型中，所有结果均与客观测量的视力障碍显着相关，包括抑郁症状（比值比 [OR]，1.81；95% CI，1.26-2.58）、焦虑症状（OR，1.74；95% CI，1.13-2.67） ）和严重的社会隔离（OR，2.01；95% CI，1.05-3.87）。同样，抑郁症状（OR，2.37；95% CI，1.44-3.88）和焦虑症状（OR，2.10；95% CI，1.09-4.05），但没有严重的社会孤立症状（OR，2.07；95% CI，0.78- 5.49）与自我报告的视力障碍显着相关。结论和相关性在这项研究中，视力障碍与多种心理社会结果相关，包括抑郁和焦虑症状以及社会孤立。这些发现提供了证据支持优先开展旨在增强视力障碍人群的健康和包容性的研究。