Improving referral of depressed elderly in low vision rehabilitation

In international studies it has been suggested that one-third of visually
impaired elderly experience clinically significant depressive symptoms.
Depression is negatively associated with low vision rehabilitation (LVR)
outcomes. It aggravates existing disability, and function can improve when
treated adequately. However, in the Netherlands there is no information on the
prevalence and severity of depression in visually impaired elderly. Thinking
about the rapidly increasing population of visually impaired elderly,
recognising depression is essential to filter out persons that will initially
not benefit as much from LVR. LVR centres need to make efficient choices in
which patients should be treated in their centres or initially elsewhere, e.g.
psychological or psychiatric care. Also, insight into the prevalence and
severity of depression and specific vulnerability factors may help us to
develop specialised interventions in the future and to recognise depressed
visually impaired elderly in practise.

The general objective of our study is to improve the outcome of LVR by adequate
referral of depressed visually impaired elderly patients who are entering the
LVR process. First, it is important to know the prevalence and severity of
depressive symptoms. Second, getting insight into vulnerability factors is
essential to recognise depression and to determine how depressed visually
impaired patients can be helped in an intervention.
This study will give insight into the prevalence and severity of depressive
symptoms in visually impaired elderly in the Netherlands and how to recognise,
to treat and where to refer them. We eventually expect more patients to benefit
from LVR.

The second phase of our study, i.e. the screening of visually Impaired older
adults for depression has a cross-sectional design.

It is possible that a number of (depressed) patients will find it burdensome to
participate in the interview. However, to minimize the burden we will conduct
the interviews in their home environment. Furthermore, patients will be offered
psychological assistance or assistance by a social worker if necessary. The
research project is important, because depression is negatively associated with
LVR outcomes. It aggravates existing disability, and function can improve when
treated adequately. However, in the Netherlands there is no information on the
prevalence and severity of depression in visually impaired elderly. Thinking
about the rapidly increasing population of visually impaired elderly,
recognising depression is essential to filter out persons that will initially
not benefit as much from LVR. LVR centres need to make efficient choices in
which patients should be treated in their centres or initially elsewhere, e.g.
psychological or psychiatric care. Also, insight into the prevalence and
severity of depression and specific vulnerability factors may help us to
develop specialised interventions in the future and to recognise depressed
visually impaired elderly in practise. In summary, this study will give insight
into the prevalence and severity of depressive symptoms in visually impaired
elderly in the Netherlands and how to recognise, to treat and where to refer
them. We eventually expect more patients to benefit from LVR. Therefore, we
believe that the proposed study weighs up to a possible burden that may be
caused by the interview.