Fifty ophthalmology clinic outpatients (age 65 and older) from the comprehensive eye and neuro-ophthalmology clinics at the University of Iowa were asked to:
- Complete a short questionnaire to determine if the patients functioned well and independently in their activities of daily living,
- Answer a single question on depression, and
- Complete a simple clock-drawing task to screen for dementia.
Twelve percent of the study participants were identified with functional impairment, 20 percent showed signs of depression and 20 percent showed signs of dementia.
Study author Andrew G. Lee, MD said, "Early detection can help patients obtain early treatment and help the quality of life for both patients and their caretakers." Dr. Lee, an associate professor in the ophthalmology, neurology and neurosurgery at the University of Iowa added, "Unfortunately, very little screening is done now."
The study is important because of the impending dramatic demographic shift toward an older population that is taking place in the United States. "With increasing numbers of geriatric patients entering eye clinics, it may be important to recognize and possibly screen elderly patents for treatable geriatric conditions." The study said there are several reasons why screening at eye clinics may be valuable. Among them are:
- Ophthalmology clinics and practices tend to have a high number of elderly patients compared to other medical and surgical clinics.
- Screening for depression, dementia and functional impairment has proven useful in other clinical settings. Easy-to-use screening tests have been used for years by geriatricians.
- Patients with these conditions may not be able to cognitively process or interpret what they are looking at. The patient then misinterprets an inability to comprehend text or sort out complex visual information as a visual problem.
Academy media spokesperson and glaucoma specialist Ruth Williams, MD, of Wheaton, Ill., said she often sees patients with unrecognized and untreated depression. "A screening tool, such as this, not only serves to identify the patients at risk, but serves as a tool for physicians to open discussions with their elderly patients."
The study authors said the goal of their work was not to make ophthalmologists into geriatricians, but to increase geriatrics expertise and awareness by ophthalmologists. This would allow them to make appropriate referrals for more comprehensive geriatrics assessment. "In a way, ophthalmologists may improve the overall health care as well as ocular health care in older adults," the study stated.
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons--Eye M.D.s--with more than 27,000 members worldwide. For more information about eye health care, visit the Academy's partner Web site, the Medem Network, at www.medem.com/eyemd. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.