Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

Jongenelis, K.; Pot, Anne Margriet; Eisses, A. M. H.; Gerritsen, Debby L.; Derksen, M.; Beekman, Aartjan T.F.; Kluiter, H.; Ribbe, Miel W.

doi:10.1002/gps.1398

Cited by 128 publications

(123 citation statements)

References 30 publications

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“…This self-report measure has shown adequate diagnostic accuracy in the institutional setting, including residents with mild to moderate cognitive impairment. The overall discrimination of the ten-item GDS was 0.86 for identifying clinical major or minor depression among nursing home patients, with sensitivity rates of 75-86% and specificity rates of 70-77% for the optimal cut-off score of 4 or higher (Shah et al 1996;Jongenelis et al 2005). Although the ten-item GDS has not been validated for Spanish population, translation and adaption of longer 15-and 30-item versions to the Spanish language were straightforward and showed similar psychometric properties to those of the original questionnaires (Izal & Montorio, 1993;Martínez de la Iglesia et al 2002).…”

Section: Baseline Data Collectionmentioning

confidence: 96%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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Background. Studies on depression and mortality in nursing homes have shown inconclusive findings, and none has studied the role of detection. We sought to measure the association of depression with long-term all-cause mortality in institutionalised older people and evaluate a potential modification in the association by its detection status.Methods. We selected a stratified cluster sample of 591 residents aged 75 years or older (mean age 84.5 years) living in residential and nursing homes of Madrid, Spain, who were free of severe cognitive impairment at the 1998-1999 baseline interview. Mortality was ascertained until age 105 years or September 2013 (median/maximum follow-up 4.8/15.2 years) through linkage to the Spanish National Death Index. Detected depression was defined at baseline as a physician's diagnosis or antidepressant use, undetected depression as significant depressive symptoms (score of 4 or higher on the ten-item version of the Geriatric Depression Scale) without documented diagnosis or treatment, and no depression as the absence of diagnosis, treatment, and symptoms. Constant and age-dependent hazard ratios for mortality comparing detected and undetected depression with no depression were estimated using Cox models, and absolute years of life gained and lost using Weibull models.Results. The baseline prevalences of detected and undetected depression were 25.9 and 18.8%, respectively. A total of 499 participants died during 3575 person-years of follow-up. In models adjusted for age, sex, type of facility, number of chronic conditions, and functional dependency, overall depression was not associated with long-term all-cause mortality (hazard ratio 0.87, 95% confidence interval (CI): 0.70-1.08). However, compared with no depression, detected depression showed lower mortality (hazard ratio 0.63, 95% CI: 0.46-0.86), while undetected depression registered higher, not statistically significant, mortality (hazard ratio 1.35, 95% CI: 0.98-1.86). The median life expectancy increased by 1.8 years (95% CI: −3.1 to 6.7 years) in residents with detected depression and decreased by 6.3 years (95% CI: 2.6-10.1 years) in those undetected. Results were more marked in women than men and they were robust to the exclusion of antidepressants from the definition of depression and also to the use of a stricter cut-off for the presence of depressive symptoms.Conclusions. The long-term mortality risk associated with depression in nursing homes depends on its detection status, with better prognosis in residents with detected depression and worse in those undetected. The absolute impact of undetected depressive symptoms in terms of life expectancy can be prominent.

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Section: Baseline Data Collectionmentioning

confidence: 96%

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Damián

Pastor-Barriuso

Valderrama-Gama

et al. 2016

Epidemiol Psychiatr Sci

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“…On the other hand, Lach et al (2010) built evidence for the use of the GDS-15 in populations that include people with mild to moderate dementia. Additionally, several studies (Conradsson et al, 2013;Jongenelis et al, 2005;McGivney et al, 1994;Smalbrugge et al, 2008) attested that the GDS-15 seems to be valid for people with mild cognitive impairments -assessed by the Mini-Mental State Examination (MMSE; Folstein et al, 1975)-, but it is unclear if the scale can be used with people with lower cognitive functioning (Conradsson et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Does the 15-item Geriatric Depression Scale function differently in old people with different levels of cognitive functioning?

Chiesi

Primi

Pigliautile

et al. 2018

Journal of Affective Disorders

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A B S T R A C TBackground: The 15-item version of the Geriatric Depression Scale (GDS-15) is widely employed to screen depression among elderly but little is known about the scale functioning in cognitively impaired individuals when compared to normal ones. The aim of the current study is to investigate Differential Item Functioning (DIF) across groups of older people that differ in terms of cognitive functioning applying Item Response Theory (IRT)-based analyses. Methods: Data from an Italian multi-centric clinical-based study on cognitive impairment and dementia in old people were employed (N = 1903; Age: M = 77.33, SD = 7.05, 62% women). All the participants underwent a comprehensive evaluation (including clinical examination, laboratory screening, neuroimaging, and cognitive and behavioral assessments) and they were assigned to three different groups on the basis of their cognitive functioning (normal, mild cognitive impairment, cognitive impairment) Results: Two items showed uniform DIF but their differential functioning does not propagate to the GDS-15 total scores in such a way that a differential interpretation is needed Limitations: Whereas an advantage of the study is the large sample size, the relatively small size of the mild cognitive impairment group might reduce the stability of the present results Conclusions: Since a screening tool for elderly is intended to apply to everyone in the target population, the current findings support the clinical utility of the GDS-15 as screening tool for depression.

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“…Therefore, in several settings, shortened versions have been introduced, of which the GDS-15 and the GDS-10 have been found to be acceptable for the nursing home population. (Sheik and Yesavage, 1986;D'Ath et al, 1994;Jongenelis et al, 2005). Furthermore, the GDS-12R was specifically constructed for nursing and residential home populations (Sutcliffe et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

Construction and validation of a patient‐ and user‐friendly nursing home version of the Geriatric Depression Scale

Jongenelis

Gerritsen

Pot

et al. 2007

Int J Geriat Psychiatry

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SUMMARYObjective To construct a patient-and user-friendly shortened version of the Geriatric Depression Scale (GDS) that is especially suitable for nursing home patients. Methods The study was carried out on two different data bases including 23 Dutch nursing homes. Data on the GDS (n ¼ 410), the Mini Mental State Examination (n ¼ 410) and a diagnostic interview (SCAN; n ¼ 333), were collected by trained clinicians. Firstly, the items of the GDS-15 were judged on their clinical applicability by three clinical experts. Subsequently, items that were identified as unsuitable were removed using the data of the Assess project (n ¼ 77), and internal consistency was calculated. Secondly, with respect to criterion validity (sensitivity, specitivity, area under ROC and positive and negative predictive values), the newly constructed shortened GDS was validated in the AGED data set (n ¼ 333), using DSM-IV diagnosis for depression as measured by the SCAN as 'gold standard'. Results The eight-item GDS that resulted from stage 1 showed good internal consistency in both the Assess data set (a ¼ 0.86) and the AGED dataset (a ¼ 0.80). In the AGED dataset, high sensitivity rates of 96.3% for major depression and 83.0% for minor depression were found, with a specificity rate of 71.7% at a cut-off point of 2/3. Conclusion The GDS-8 has good psychometric properties. Given that the GDS-8 is less burdening for the patient, more comfortable to use and less time consuming, it may be a more feasible screening test for the frail nursing home population.

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Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients

Cited by 128 publications

References 30 publications

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Association of detected depression and undetected depressive symptoms with long-term mortality in a cohort of institutionalised older people

Does the 15-item Geriatric Depression Scale function differently in old people with different levels of cognitive functioning?

Construction and validation of a patient‐ and user‐friendly nursing home version of the Geriatric Depression Scale

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