Association of objective visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years in low/middle-income countries.

Journal: The British journal of ophthalmology

Volume: 106

Issue: 11

Year of Publication: 2022

Affiliated Institutions:  The Cambridge Centre for Sport and Exercise Science, Anglia Ruskin University-Cambridge Campus, Cambridge, UK lee.smith@aru.ac.uk. Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea. Faculty of Science and Engineering, Anglia Ruskin University-Cambridge Campus, Cambridge, UK. Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK. Italian Agency for Development Cooperation, Khartoum, Sudan. Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France. School of Social Work, University of Southern California, Los Angeles, California, USA. Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Calgary, Alberta, Canada. Institute of Mental Health Sciences, Ulster University, Coleraine, Londonderry, UK. Department of Medicine, University of Palermo, Palermo, Italy. Research and development unit, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.

Abstract summary 

There is currently limited literature on the association between visual impairment and suicidal thoughts and behaviours, especially among older adults from low/middle-income countries (LMICs). Thus, we aimed to investigate the associations of objectively measured distance visual impairment with suicidal ideation and suicide attempts among adults aged ≥50 years from six LMICs and to identify potential mediators.Cross-sectional, community-based, nationally representative data from the WHO Study on global AGEing and adult health were analysed. Objective distance visual acuity was measured using the tumbling E logMAR chart, and vision impairment was categorised as none, mild, moderate and severe. Self-reported information on past 12-month suicidal ideation and suicide attempts was also collected. Multivariable logistic regression and mediation analysis were conducted.Data on 34 129 individuals aged ≥50 years (mean (SD) age, 62.4 (16.0) years; 47.9% men) were analysed. After adjustment for potential confounders, compared with no visual impairment, severe visual impairment was significantly associated with suicidal ideation (OR=9.50; 95% CI=2.47 to 36.52). Moderate and severe visual impairment were significantly associated with a 2.22 (95% CI=1.14 to 4.35) and 11.50 (95% CI=1.44 to 91.88) times higher odds of suicide attempts, respectively. Disability, poor self-rated health, mobility and loneliness explained 14.0%, 9.3%, 7.2% and 6.3% of the association between moderate/severe visual impairment and suicide attempts, respectively.Interventions to reduce suicidal ideation and suicide attempts among older adults with visual impairment in LMICs are required, targeting identified mediators, while using tested strategies for suicide prevention per se in LMICs may yield beneficial outcomes.

Authors & Co-authors:  Smith Lee L Shin Jae Il JI Barnett Yvonne Y Allen Peter M PM Lindsay Rosie R Pizzol Damiano D Jacob Louis L Oh Hans H Yang Lin L Tully Mark A MA Veronese Nicola N Koyanagi Ai A

Study Outcome 

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Statistics
Citations : 
Authors :  12
Identifiers
Doi : 10.1136/bjophthalmol-2021-318864
SSN : 1468-2079
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
epidemiology;public health;vision
Study Design
Study Approach
Country of Study
Publication Country
England