Risk of Depression, Anxiety, and Suicidal Behavior in Older Adults With Severe Vision Loss

Purpose: To evaluate the risk of developing depression, anxiety, and suicidal behavior in older adults newly diagnosed with blindness. Methods: A retrospective cohort study was conducted using the TriNetX Analytics Network, analyzing de-identified electronic health records from 2006 to 2024. Patients ages ≥60 years with a diagnosis of blindness based on International Classification of Diseases, Tenth Revision, Clinical Modification codes were identified. Patients were matched 1:1 to control subjects with normal vision using propensity score matching (PSM), based on demographics and psychiatric comorbidities. Primary outcomes included incident major depressive episodes, persistent depression, anxiety disorders, and suicide attempts at 1-, 3-, and 5-year follow-up intervals. Results: After PSM, 143 668 subjects were included in each cohort. Compared with matched controls, blindness was associated with increased risk of major depression at 1 year (relative risk [RR] 1.69; 95% confidence interval, 1.64-1.72), 3 years (RR 1.47), and 5 years (RR 1.39). Similar trends at 1, 3, and 5 years were observed for risk of persistent depression (RRs of 1.88, 1.43, and 1.29, respectively), anxiety (RRs of 1.92, 1.45, and 1.30, respectively), and suicide attempts (RRs of 8.50, 5.26, and 3.42, respectively). Risks remained elevated in validation and subgroup analyses. Suicide attempts were particularly high among those with preexisting depression (suicide attempt rate at 1 year, 0.24%). Mental health risks were highest within the first year after diagnosis and declined over time but remained significantly elevated. Conclusions: Blindness in older adults is associated with significantly increased risks of depression, anxiety, and suicide, especially within the first year of diagnosis. These findings suggest the need for mental health screening and early psychosocial intervention in newly blind patients to mitigate long-term psychiatric morbidity.