Comorbid Depression and Anxiety Risk in Older Individuals with Geographic Atrophy: A US Claims Data Analysis

Geographic atrophy (GA), an advanced stage of nonexudative age-related macular degeneration (AMD), is associated with progressive central vision loss and blindness. While the association between GA and impaired vision-related quality of life has been established, understanding of the co-occurrence of anxiety and depression in individuals with GA is limited.

We conducted a retrospective, noninterventional, cohort study analyzing data from three large US databases (Optum's de-identified Clinformatics^® Data Mart Database [Clinformatics^®], Merative™ MarketScan^® Commercial and Medicare Databases [MarketScan], and IQVIA US PharMetrics^® [PharMetrics]), employing a common data model. Patients aged ≥ 50 years with a diagnosis of GA were included and were matched to patients without GA in a 1:2 ratio using propensity score matching to create a non-GA/AMD control population. Outcomes included time from GA diagnosis to first interaction with a health care provider for depression or anxiety and health care resource utilization (HCRU). Relative risks (RRs) and 95% confidence intervals (CIs) were calculated between GA and control cohorts with stratification by eye and subfoveal involvement.

The Clinformatics^®, MarketScan, and PharMetrics datasets included 44,595, 9468, and 27,427 patients with GA, respectively. Across databases, mean (SD) age ranged from 75.7 (8.3) to 80.5 (7.2) years, and 61% to 64% were female. Comorbid depression and anxiety risk were higher in patients with GA versus controls across datasets (depression RR [95% CI] 1.24 [1.13-1.35] to 1.36 [1.31-1.41]; anxiety RR [95% CI] 1.17 [1.06-1.30] to 1.33 [1.27-1.39]), with the greatest risk seen in those with bilateral GA with subfoveal involvement. HCRU was also significantly higher in patients with GA versus controls.

This study found a higher risk for comorbid depression or anxiety in patients with GA versus propensity score-matched controls. Risk was greatest among those with bilateral GA with subfoveal involvement. These findings highlight the important mental health burden experienced by patients with GA.