Association between depression and dry eye disease in an elderly population

A population-based cross-sectional study to investigate the association between depression and dry eye disease (DED) in a community-dwelling elderly population. The subjects were 657 Korean elders ≥ 65 years of age randomly selected from an official household registration database in Yongin, Korea. DED symptoms were assessed using the six-item Dry Eye Questionnaire. DED signs were evaluated using the Schirmer test, fluorescein stain score, tear film break-up time (BUT). Depression was assessed using the Korean version of the Short Geriatric Depression Scale (SGDS-K). The association between DED and depression was evaluated using logistic linear analyses. The SGDS-K score correlated with the number of positive responses in the Dry Eye Questionnaire (r = 0.229, P < 0.001), but not with tear film break-up time (r = 0.041, P = 0.139) or Schirmer test score (r = 0.048, P = 0.642). In the binary logistic regression model, female sex (P = 0.014), residence in urban areas (P < 0.001), depression (P < 0.001), and Schirmer score of ≤ 5 mm (P = 0.035) were associated with the risk of DED. Depression was associated with the risk of DED (P < 0.001) in the patients with Schirmer score > 5 mm but not in those with Schirmer score ≤ 5 mm (P = 0.290). Depression was associated with DED symptoms in subjects with normal or mildly reduced tear production.