Screening elderly patients in an outpatient ophthalmology clinic for dementia, depression, and functional impairment

Purpose: To determine the feasibility of screening for depression, dementia, and functional impairment in an ophthalmology outpatient clinic. Design: Prospective pilot survey study. Participants: Fifty consecutive ophthalmology clinic outpatients. Methods: Consecutive patients more than 64 years of age with visits to the comprehensive eye clinic and the neuroophthalmology clinic at the University of Iowa were assessed. Suitable subjects were asked to complete a short questionnaire on instrumental activities of daily living, to answer a single question on depression, and to complete a clock drawing task in the office waiting room or examination room. Results: The 50 questionnaires reviewed showed that most respondents were functional (94%) in instrumental activities of daily living, had normal clock drawing results (80%), and were not depressed (80%). A significant minority, however, were identified by the screening to have functional impairment (6%), abnormal clock drawing results (20%), or depression (20%), and these patients were offered geriatric assessment. The tests were rapid (fewer than 5 minutes to perform) and easy to administer. Conclusions: Screening for geriatric syndromes in the eye clinic was rapid, easy to perform, and detected a significant number of patients with functional disability, depression, and possible dementia.