The Mediator Effect of Visual Impairment in the Relationship between Poor Oral Health and Depression

Abstract

Purpose: Visual impairment (VI) with a global estimate of 161 million has been associated with a lot of health concerns and physical conditions. This study investigates the mediator effect of visual impairment on the relationship between poor oral health and depression. Methods: This was a cross-sectional study involving secondary analysis using data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS). Self-reported visual impairment was categorized as no and yes (a little difficulty, moderate difficulty, extreme difficulty and unable to do because of eyesight). The responses to oral health were dichotomized to 0-5 teeth removed and 6+ teeth removed (poor oral health). For depression, we used physician-diagnosed depression (yes or no) and self-rated depression (validated Patient Health Questionnaire-8) (PHQ-8). We examined the association between visual impairment and depression using multivariable logistic regression accounting for the survey’s complex design. Results: After adjusting for socio-demographic variables, health behavior, BMI and diabetes; the model produced a significant relationship between poor oral health and depression. Controlling for visual impairment resulted in the attenuation of the effect poor oral health has on depression. Furthermore, after improving eyesight, a previously significant relationship between poor oral and depression became non-significant. Conclusion: Controlling for visual impairment, by treating or preventing visual impairment, in patients with poor oral health, merely indicates a reduction in the outcome of depression.