AMD Patients See Depression Risk Reduced with Behavioral, Occupational Therapy

A new study funded by the National Eye Institute (NEI) has found that behavior activation and low-vision occupational therapy can reduce the risk of depression by 50% in patients with age-related macular degeneration (AMD). The results were published in the journal Ophthalmology.

The Low Vision Depression Prevention Trial (VITAL) enrolled 188 patients with bilateral AMD, a best-corrected vision of <20/70, mild depressive symptoms, and risk for developing clinical depression based on a nine-item depression subtest of the Patient Health Questionnaire (PHQ-9). The average age of the patients was 84 years and 70% were female. The trial participants were prescribed low-vision devices like handheld magnifiers after two visits with an optometrist and then randomly assigned to two groups.

One group received behavior activation from a specially training occupational therapist to assist in guidance on using the low-vision devices, making changes around the home (such as using brighter lights and high-contrast tape), increasing social activities, and helping set personal goals split into manageable steps. The control group discussed their difficulties with a therapist but did not receive behavior activation or low-vision occupational therapy. All participants engaged in six one-hour therapy sessions in their homes over a two-month period and were permitted to take antidepressants, although <10% did so. All received AMD medical management from their primary eye care providers.

RELATED: Fewer Ophthalmologists Means Less Diabetic Eye Care

After 4 months, 12.6% of those in the behavior activation group developed clinical depression vs. 23.4% in the control group. Among those with vision <20/100, the greatest benefits of behavior activation were seen with a 60% reduction in risk of clinical depression compared to controls. After adjusting for vision status, physical health, and baseline PHQ-9 score, behavior activation lowered the risk of depression by 50% vs. the control treatment.

The authors hope that these findings will lead to similar approaches in the prevention and treatment of depression in patients with AMD.

For more information visit NIH.gov.

Loading links....