Validation of the five‐item version of the Geriatric Depression Scale (GDS‐5) in a Turkish elderly population

Abstract

Background: Late-life depression is a geriatric syndrome which should be taken seriously. Many clinical scales have been developed for the screening of geriatric depression. Most of these have been validated at different times and in diverse populations. A five-question version of the Geriatric Depression Scale (GDS-5) was developed in 1997. This test has been validated and used in different populations. In the present study, we plan to validate the GDS-5 for the Turkish elderly population. Methods: Patients aged 60 years and older who applied to the Geriatrics Clinic of our hospital between November 2018 and November 2019 were included in the study. We compared the effectiveness of Yesavage Geriatric Depression Scale-30 (YGDS-30) and GDS-5 in screening depression, based on Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) depression criteria. Results: Four hundred participants were included in the study. A significant positive correlation was found between the DSM-5 scale and the GDS-5 scale (rho = 0.726, P <0.001). According to DSM-5, YGDS-30 and GDS-5, 112 participants (28%), 154 patients (%38.5) and 199 patients (%49.8) were diagnosed with depression respectively. When the cut-off value was taken as ≥2, the sensitivity, specificity, positive predictive and negative predictive values for the GDS-5 scale were determined as 96%, 68%, 54%, and 98%, respectively. We obtained these diagnostic measures with 95% confidence intervals. Conclusion:This study demonstrated the validity and reliability of the GDS-5 for Turkish elderly populations. This five-question scale will be significant in daily use to screen for depression in elderly individuals with multiple problems.

The development of a short depression screening tool in older adults

“…2 Thus, we found that the TGDS-5 and the original GDS-5 have only one common item ('Do you often get bored?'). 1,2 Other items differed from the GDS-5; however, the Cronbach's α of the TGDS-5 increased to 0.807, that is, the internal consistency coefficient was 'good'. 1,2 In our study, although the specificity and positive predictive value (PPV) of the GDS-5 were high, its sensitivity value was significantly lower, and low a sensitivity value for a screening tool limits its use.…”

“…1,2 However, due to the fact that these studies were conducted in two different sociocultural regions of Turkey, the sensitivity of the GDS-5 was higher (96.4% vs 85.8%) and the specificity was lower (67.7% vs 92.1%) depending on the differences in the education levels of the participants. 1,2 However, the important finding common to both studies is that the Cronbach's α value is below 0.7, that is, the internal consistency coefficient is at a questionable level, which means that the GDS-5 or some of its items do not represent respondents with depression. 3,4 To solve this problem, by performing Kappa consistency analysis, the inter-rater reliability of each of the items in the long form of the GDS can be checked, and community-specific short forms can be produced with those items having the highest kappa values.…”

“…We read with great interest the study of Gokcekuyu et al, which has just been published in your journal. 1 In this study, the authors aimed to validate a fivequestion version of the Geriatric Depression Scale (GDS-5) in the elderly Turkish population, but actually the GDS-5 was previously revalidated in Turkish by Dokuzlar et al 2 The study of Gokcekuyu et al seems valuable; however, some methodological considerations need to be taken into account when validating the short forms of scales used for screening. 1 Just like in this study, Dokuzlar et al's aimed to validate the GDS-4 and GDS-5 in Turkish elderly patients, and outpatients to geriatric clinics were included in both studies.…”

“…1 In this study, the authors aimed to validate a fivequestion version of the Geriatric Depression Scale (GDS-5) in the elderly Turkish population, but actually the GDS-5 was previously revalidated in Turkish by Dokuzlar et al 2 The study of Gokcekuyu et al seems valuable; however, some methodological considerations need to be taken into account when validating the short forms of scales used for screening. 1 Just like in this study, Dokuzlar et al's aimed to validate the GDS-4 and GDS-5 in Turkish elderly patients, and outpatients to geriatric clinics were included in both studies. 1,2 However, due to the fact that these studies were conducted in two different sociocultural regions of Turkey, the sensitivity of the GDS-5 was higher (96.4% vs 85.8%) and the specificity was lower (67.7% vs 92.1%) depending on the differences in the education levels of the participants.…”

“…1 Just like in this study, Dokuzlar et al's aimed to validate the GDS-4 and GDS-5 in Turkish elderly patients, and outpatients to geriatric clinics were included in both studies. 1,2 However, due to the fact that these studies were conducted in two different sociocultural regions of Turkey, the sensitivity of the GDS-5 was higher (96.4% vs 85.8%) and the specificity was lower (67.7% vs 92.1%) depending on the differences in the education levels of the participants. 1,2 However, the important finding common to both studies is that the Cronbach's α value is below 0.7, that is, the internal consistency coefficient is at a questionable level, which means that the GDS-5 or some of its items do not represent respondents with depression.…”