Wednesday, 20 August 2003
This presentation is part of : Late-Life Depression and Co-existing Conditions

S074-002 Preventing Depression and Disability in Age-Related Macular Degeneration (AMD)

Barry Rovner, Department of Psychiatry and Human Behavior, Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, PA, USA

Age-related Macular Degeneration (AMD), is the most common cause of blindness in older adults and limits the ability to read, travel, complete housework, and prepare meals. It affects 2 million persons now and will affect 6 million by 2020. AMD provides a useful model to investigate the inter-relationships between disease, depression and disability because it is common, quantifiable in terms of its severity (e.g. visual acuity), and has no symptom overlap with depression. However, AMD increases the risk of depression: the prevalence of depression is 27.5% and its incidence over 6 months is 30%. Because depression is common and itself disabling, finding ways to prevent it and reduce disability are extremely important.

We will describe an ongoing randomized controlled clinical trial of Problem-Solving Therapy (PST) to prevent depression in this high-risk group. PST’s conceptual model posits that inaccurate appraisals of problems and/or difficulty implementing solutions leads to depression.

The life-span theory of control guides this research: PST teaches patients problem-solving skills and helps to regulate emotion. We will present preliminary data on PST’s efficacy to prevent depression in older persons with visual impairments. As the prevalence and disabling effects of AMD increase, identifying interventions such as PST to prevent depression and disability will become extremely important.

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