Contribution of multiple pathways to the relationship between visual impairment and depression: Explaining mental health inequalities among older Chinese adults

Though visual impairment is a strong predictor for late-life depression, the underlying mechanisms remain unclear. This paper investigated contribution of material, psychosocial and behavioural pathways in mediating vision-depression association. The study used cross-sectional data from WHO Study on Global AGEing Adult Health (SAGE), including 11,531 older Chinese adults. Depression was assessed based an adaptation ICD-10 diagnostic criteria. Causal mediation analyses using inverse odds ratio weighting (IORW) approach were conducted to assess roles material (wealth quintiles perceived income inadequacy), (leisure activity, BMI sleep) factors (social participation, trust sense safety). participants with had 43% higher depression than those normal vision. In analysis, pathway contributed most total effect, accounting 31.7% it. proportion effect which mediated by 24.2% 22.5% respectively. When these three mediators considered together full model, they accounted 43.5% depression. There still existed unexamined factors. design might restrict temporal sequence. Visually-impaired population as high-risk group should be provided better access screening, diagnosis treatment Material, may serve relevant points entry developing intervention programmes improve mental health conditions visually-impaired people.