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Major and Subthreshold Depression Among Older Adults Seeking Vision Rehabilitation Services

Received March 30, 2004; revised July 15, August 23, 2004; accepted August 24, 2004. From Lighthouse International (AH,JPR) and the Montefiore Medical Center (GJK). Send correspondence and reprint requests to Amy Horowitz, D.S.W., Senior Vice President for Research and Evaluation, Director, Arlene R. Gordon Research Institute, Lighthouse International, 111 East 59th St., New York, NY 10022. e-mail: ahorowitz{at}lighthouse.org
© 2005 American Association for Geriatric Psychiatry

Objective: Authors examined the potential risk factors of major and subthreshold depression among elderly persons seeking rehabilitation for age-related vision impairment. Methods: Participants (N=584), age 65 and older, with a recent vision loss, were new applicants for rehabilitation services. Subthreshold depression was defined as a depressive syndrome not meeting criteria for a current major depression (i.e., minor depression, major depression in partial remission, dysthymia) or significant depressive symptomatology. Results: Seven percent of respondents had a current major depression, and 26.9% met the criteria for a subthreshold depression. Poorer self-rated health, lower perceived adequacy of social support, decreased feelings of self-efficacy, and a past history of depression increased the odds of both a subthreshold and major depression, versus no depression, but greater functional disability and experiencing a negative life event were significant only for a subthreshold depression. Only a history of past depression was significant in increasing the odds of having a major versus a subthreshold depression. Conclusion: Results highlight similarities in characteristics of, and risk factors for, subthreshold and major depression. Future research is needed to better understand both the trajectory and treatment of subthreshold depression, relative to major depressive disorders.

Key Words: Depression • Visual Impairment • Physical Disability

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