Comparing Patient-Reported Outcomes Measure Information System Depression Scale with Legacy Depression Measures in a Community Sample of Older Adults with Varying Levels of Cognitive Functioning

Abstract

Objectives This study evaluated the utility of Patient-Reported Outcomes Measure Information System Depression Scale (PROMIS-8a) compared to selected “Legacy” depression scales including Montgomery-Asberg Depression Rating Scale (MADRS), Geriatric Depression Scale (GDS), and GDS-Short Form (GDS-SF). Additionally, the measures’ properties were assessed across levels of cognitive functioning. Methods This cross-sectional analysis was extracted from a prospective cohort study. PROMIS-8a and Legacy depression measures were administered to individuals aged ≥70 grouped by cognitive status based on the Saint Louis University Mental Status Examination. McNemar tests were run to determine if measures categorized the absence or presence of depression differently and item analysis evaluated classification discrepancies. Results Sample mean age was 78, the majority was female (71%), Caucasian (79%), with at least a high-school education (89%). The percentage of individuals with at least mild depression was similar across measures (20.7% PROMIS-8a; 19.0% MADRS; 17.9% GDS; 13.9% GDS-SF). PROMIS-8a total score correlated moderately with MADRS (r=.56, df=295, p<.01), GDS (r=.68, df=291, p<.01), and GDS-SF (r=.60, df=291, p<.01) and predictive validity of the measures was similar. There were no significant mean differences on depression measures by cognitive status. Conclusions While all measures identified a similar percent of depressed individuals, the classification differed by measure. Item analysis showed that PROMIS-8a was more likely to identify feelings of dysphoria, and the MADRS and GDS were more likely to identify physiological aspects of depression. Given the brevity and ease of administration of the PROMIS-8a, it appears to be a useful depression screen for community-dwelling older adults.

Comparison of patient-reported outcomes measurement information system and legacy instruments in multiple domains among older veterans with chronic back pain

“…In a retrospective review of an outcomes database, PROMIS Pain Interference, Physical Function, and Pain Intensity instruments correlated strongly with traditional disability measures in patients with back and neck pain [ 41 ]. In the present sample of older Veterans, results were similar to those previously reported in older Veterans who are known to have additional burden of physical and psychiatric comorbidity [ 42 , 43 ]. Mental health conditions can impact patients’ perceptions of their musculoskeletal disease and influence their self-reported outcome measures.…”

“…Moreover, PROMIS instruments appear to function well in older adults with cognitive impairment. For instance, in a study conducted on community dwelling older adults with varying degrees of cognitive impairment, Levi et al evaluated the utility of PROMIS Depression Scale compared to legacy depression instruments (Montgomery-Asberg Depression Rating Scale, Geriatric Depression Scale (GDS), and GDS-Short Form) and found no statistically significant differences in depression scores by cognitive status group between the instruments [43].…”

Effects on sedentary behaviour of an approach to reduce sedentary behaviour in patients with minor ischaemic stroke: A randomised controlled trial

“…30 A score of 6 or more was considered as having “depressive symptoms” with reference to previous studies. 31 The reliability and validity of the GDS15 have been reported, 30,32 and used in previous stroke patients. 33…”

“…30 A score of 6 or more was considered as having "depressive symptoms" with reference to previous studies. 31 The reliability and validity of the GDS15 have been reported, 30,32 and used in previous stroke patients. 33 Sleep disorders were assessed using the Japanese version of the Pittsburgh Sleep Quality Index, which comprises questions about sleep quality, time one falls asleep, sleep duration, and the use of sleeping pills, 34 each of which was coded on a 4-point scale (0-3 points), with a score ranging from 0 to 21 points.…”

End points for sickle cell disease clinical trials: patient-reported outcomes, pain, and the brain

“…Although some work has been done to compare it to older instruments, the Depression measure may be less sensitive to the neurovegetative symptoms of Major Depressive Disorder (MDD) than some other measures. 51 Great caution must be exercised in equating the "depression" measured by these instruments with a diagnosis of MDD or generalizing from changes in these scales in SCD to conclusions about the efficacy of treatments for MDD in SCD.…”