The Relationship Between Blepharoptosis and Psychosocial Health in the All of Us Research Program.

Purpose: To investigate the association between blepharoptosis (ptosis) and psychosocial stress levels, depression, and anxiety in a diverse population of American adults.

Methods: Utilizing data from the National Institutes of Health's All of Us Research Program, we analyzed responses from 104,456 participants who completed psychosocial assessments. Participants with a history of a ptosis diagnosis were 1:3 matched with controls using propensity score calculated based on demographics and comorbidities. Univariate and multivariable regression models were used to evaluate associations.

Results: Among 1,032 participants (mean age: 70.0 years, 33.6% male) with ptosis, the prevalence of depression and anxiety (15.3% vs. 5.2%; p < 0.001) was significantly higher (43.7% vs. 18.2%; p < 0.001) compared to 3,096 matched controls. Multivariable analysis revealed increased odds of depression (OR: 3.25; 95% CI: 2.78-3.80; p < 0.001) and anxiety (OR: 3.13; 95% CI: 2.47-3.96; p < 0.001) among those with ptosis. Female participants with ptosis had greater odds of depression (OR: 3.44 vs. 2.90) and anxiety (OR: 3.13 vs. 3.04) compared with males. In univariate analysis, participants with ptosis had greater scores in the University of California Los Angeles Loneliness Scale (18.53 vs. 18.23; p = 0.03) and Everyday Discrimination Scale (0.62 vs. 0.57; p = 0.02) than controls. However, these associations were not significant in the multivariate analysis. In multivariate analysis, female participants with ptosis had greater Everyday Discrimination Scale scores than matched controls (1.10 vs. 1.02; p = 0.004).

Conclusions: Ptosis is significantly associated with higher rates of depression and anxiety, particularly in females. This underscores the need for comprehensive treatment approaches that address both aesthetic and psychological needs.