Mental health burden associated with specific ocular conditions among Medicare Advantage beneficiaries with type 2 diabetes: examining the impact of glaucoma, cataracts, retinopathy, and dry eye on unhealthy mental health days

Objective: To examine differences in mental health burden across ocular conditions among Medicare Advantage patients with type 2 diabetes in the United States. Methods: Pooled national claims data were obtained from 992 individuals with type 2 diabetes and ocular conditions who completed the CDC Health-Related Quality of Life questionnaire between 2016 and 2020. Covariates included demographic characteristics and health conditions. A generalized linear regression model (GLM) was used to examine the association between ocular conditions and unhealthy mental health days. Stratified analyses were conducted for patients with and without dry eye disease (DED). Average marginal effects (AMEs) and adjusted predicted means were additionally calculated to aid interpretation. Results: Among these patients, 42% reported at least 1 day of poor mental health, and 28% had DED. The GLM indicated that patients with glaucoma only experienced 2.69 times more unhealthy mental health days (95% CI: 1.85-3.90). Within the DED subgroup, patients with glaucoma only experienced 7.80 times more unhealthy mental health days (95% CI: 4.61-13.88). No other ocular condition was significantly associated with unhealthy mental health days. Conclusion: Mental health burdens are associated with ocular conditions among Medicare Advantage patients with type 2 diabetes, underscoring the need for targeted interventions to address social risk factors in this population.