Individuals With Geographic Atrophy (GA) are at Greater Risk for Anxiety Disorder and Depression Compared to Individuals Without GA: A US Claims Data Analysi

Document Type

Conference Proceeding

Publication Date

6-2024

Publication Title

Investigative Ophthalmology and Visual Science

Abstract

Purpose : We assessed the risk for anxiety disorder and depression in individuals with GA compared to a matched cohort of individuals without GA.

Methods : Three US claims datasets (Optum Clinformatics, MarketScan Commercial and Medicare, and IQVIA US Pharmetrics) were investigated. GA patients were defined as those with a GA ICD-10 code (H35.31x3, H35.31x4) since 1 Oct 2015. Patients with GA or wet age-related macular degeneration code prior to 1 Oct 2015 were excluded. GA patients were 2:1 matched exactly to patients without GA on age, sex, and year of diagnosis, then propensity score matched using prior-selected patient and clinical characteristics with logistic regression. Patient follow up was capped at 4 years to minimize survival bias. Relative risks (RR) and 95% confidence intervals (CIs) were assessed in R, comparing GA patients to control patients overall, and for each GA subgroup stratified by eye and subfoveal involvement.

Results : The Optum dataset included 44,595 GA patients, MarketScan included 9,468 patients, and IQVIA included 27,427 patients. A majority of the patients were female (range: 61.2% to 64.0%) with mean ages ranging from 75.9 to 80.5 years across the three datasets. The risk for anxiety among all GA patients was higher than for controls (overall RR: 1.26 [95% CI: 1.22-1.30]). This increased risk was seen in all subgroups. The risk for depression among all GA patients (overall RR: 1.31 [95% CI: 1.28-1.35]) and all subgroups was higher compared with controls. Depression had the most pronounced increase in risk among the GA subgroup with bilateral and subfoveal involvement (overall RR: 1.44 [95% CI: 1.37-1.53]) compared to the controls.

Conclusions : Our analysis in 3 large US claims datasets demonstrated a higher risk of anxiety and depression in GA patients, indicating an additional burden of illness. The risk for these mental health diagnoses was greatest among GA patients with bilateral and subfoveal involvement. These findings highlight the need for a deeper understanding of mental health risk among GA patients and for interventions aimed at reducing disease burden and improving overall well-being.

Volume

65

Issue

7

First Page

5984

Comments

Association for Research in Vision and Ophthalmology Annual Meeting, ARVO 2024, May 5-9, 2024, Seattle, WA

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