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

Abstract

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.

Accuracy of 12 short versions of the Geriatric Depression Scale to detect depression in a prospective study of a high-risk population with different levels of cognition

“…The short GDS scales tested after stratification by cognitive level performed better in those without cognitive impairment than in those impaired, in line with previous studies (Friedman et al, 2005). Others have reported on the accuracy of the 15-item GDS being negatively affected by global cognitive impairment if the standard cutoff was retained (Chiesi et al, 2018;de Craen et al, 2003). However, the small size of the group with global cognitive impairment (n = 15) makes clear-cut inferences difficult.…”

“…To summarize, our findings shed further light on the diagnostic accuracy of the brief versions of the GDS, as called for by the authors of a recent review of the evidence (Pocklington et al, 2016). Furthermore, although we can draw no firm conclusions regarding the accuracy of the brief scales in persons with cognitive dysfunction, our results provide leads for much-needed future research that takes cognitive impairment into consideration (Chiesi et al, 2018).…”

Frailty and depression predict instrumental activities of daily living in older adults: A population-based longitudinal study using the CARE75+ cohort

“…Furthermore, the GDS has been shown to have predictive validity for mortality in populations aged �65 years with chronic heart failure, disability and cognitive impairments, suggesting it does have some utility in measuring depression in older adults [40]. However, there remains a debate about the performance of the GDS in people with cognitive impairment [41]. Depression and cognitive impairment often overlap.…”

Factor Structure and Measurement Invariance Across Gender Groups of the 15-Item Geriatric Depression Scale Among Chinese Elders

“…GDS-15 may have more practical appeal because of the time restraints faced in clinical practice (Yao et al, 2009). In addition, the scale has been translated into multiple languages and translated versions have been proved for assessing depressive symptoms in people from various ethnic backgrounds (Iwamasa et al, 1998; Liu et al, 1998; Ishine et al, 2005; Malakouti et al, 2006; Onishi et al, 2006; Chiesi et al, 2018), including ethnic Chinese people living in Western countries (Mui, 1996; Lai, 2000).…”