Demographic and Psychiatric Associations With Dry Eye in a Medicare Population

Purpose: The purpose of this study was to investigate the impact of demographic characteristics and psychiatric comorbidity on the prevalence of dry eye disease in the American geriatric population. Methods: Data were collected from a 2011 nationwide sample of Medicare beneficiaries aged 65 years and older (N = 1,321,000). Age, sex, race/ethnicity, residential area, climate region, and income, along with psychiatric comorbidities including depression and anxiety, were collected. Multivariable logistic regression models were used to assess the relationship between demographic and psychiatric factors and the prevalence of dry eye disease. Results: Among 21,059 patients with clinically significant dry eye, women had higher odds of having dry eye compared with men [odds ratio (OR) 2.03, 95% confidence interval (1.97–2.10)]. Asian and Native American patients had increased odds of having dry eye compared with White patients [OR 1.85 (1.69–2.02) and OR 1.51 (1.19–1.93)], while Black patients were less likely to have dry eye [OR 0.83 (0.79–0.87)]. Patients aged 75 to 84 years and 85+ were more likely to have dry eye compared with those aged 65 to 74 years [OR 1.49 (0.45–1.53) and OR 1.54 (1.48–1.60)]. Having both depression and anxiety were associated with higher odds of having dry eye [OR 2.38 (2.22–2.55)] compared with having depression alone [OR 1.95 (1.86–2.04)] or anxiety alone [OR 2.22 (2.10–2.35)]. Conclusions: Significant racial and regional disparities in dry eye prevalence were found. Psychiatric association with dry eye varied with age, sex, race, and residence region. Further research is needed to comprehend the underlying mechanisms, implications, and to address disparities in the diagnosis and management of dry eye.