Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment

Abstract

Objectives: The aim of this population-based study was to investigate the usefulness of the Geriatric Depression Scale 15-item version (GDS-15) to assess depressive symptoms among very old people with differing levels of cognitive function.Methods: The 834 participants were aged 85 and over. Feasibility of GDS-15 was evaluated as the proportion of people who completed the scale. Concurrent criterion validity was evaluated by calculating correlations between GDS-15 and Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS measures psychological wellbeing which is closely related with depressive symptoms. Correlations were calculated within groups according to cognitive function assessed with Mini-Mental State Examination (MMSE); 0–4, 5–9, 10–14, 15–19, 20–24, 25–27, and 28–30, using Pearson's two-sided correlation and compared using Fisher r-to-z transformation. Internal consistency of the GDS-15 was evaluated by calculating Cronbach's α in each group.Results: In total, 651 (78%) of the 834 participants completed the GDS-15. For the two MMSE-groups with scores of < 10, the proportion who completed GDS-15 were 1% and 42%, respectively, compared to 65–95% in the MMSE-groups with scores of >10. Cronbach's α in each MMSE-group ranged from 0.636 (MMSE 28–30) to 0.821 (MMSE 5–9). The level of correlation between GDS-15 and PGCMS did not significantly differ between MMSE-groups with scores of 5–27 compared to the MMSE-group with scores of 28–30.Conclusions: The GDS-15 seems to have an overall usefulness to assess depressive symptoms among very old people with an MMSE score of 10 or more. More studies are needed to strengthen the validity of GDS-15 among older people with MMSE scores of 10–14. For older people with MMSE scores lower than 10, there is a need to develop and validate other measurements.

Exploring a capacity to screen of the European Portuguese version of the 15-item Geriatric Depression Scale

“…Apóstolo et al (2017) have proposed a 6CIT score ≥ 10 as the threshold for cognitive impairment in the Portuguese population. However, given the evidence showing that the GDS can be reliably used in older adults with cognitive impairment of mild and moderate severity (Conradsson et al, 2013;Debruyne et al, 2009;Jongenelis et al, 2005), it was decided that the subjects who did not manifest severe deterioration in multiple cognitive domains should remain in the study. Therefore, only those who obtained a score > 21 on 6CIT were excluded.…”

“…Other authors (Ertan, Ertan, Kızıltan, & Uyguçgil, 2005;Huang, Hsieh, Wu, & Lu, 2017;Weintraub, Oehlberg, Katz, & Stern, 2006) have attested the reliability and validity of the GDS among patients with Parkinson's Disease. GDS has also been identified as a suitable tool for screening purpose in older adults with different gender, educational level and age (Conradsson, 2013;Chiesi et al, 2017;Dias et al, 2017).…”

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

“…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).…”

Symptom burden among people with chronic disease

“…The instrument has been shown to be reliable and valid and feasible also for people with a cognitive dysfunction (Conradsson et al 2013). The GDS is a self-report measure of depression in older adults, with "Yes/No" answers.…”