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Do the GDS and the GDS-15 adequately capture the range of depressive symptoms among older residents in congregate housing?

Published online by Cambridge University Press:  27 January 2011

Kathryn Betts Adams
Kathryn Betts Adams*
Affiliation:
Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, Ohio, U.S.A.
*
Correspondence should be addressed to: Kathryn Betts Adams, Mandel School of Applied Social Sciences, Case Western Reserve University, 10600 Euclid Avenue, Cleveland, OH 44106-7164, U.S.A. Phone: +1 216-368-6155. Email: [email protected].
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Abstract

Background: In light of inconsistencies in cut points for identifying non-major depression, this study examined the classification efficiency of the Geriatric Depression Scale (GDS and GDS-15) total scores and individual items, and four additional depressive symptoms for identification of subthreshold, minor, or criterion depression among 166 vulnerable residents of congregate housing.

Methods: Depression (combined categories of major depressive episode, minor, or subthreshold depression) was determined by the Mini-International Neuropsychiatric Interview (MINI) diagnostic interview depression module administered by telephone to 166 older residents of congregate housing facilities who also completed the 30-item GDS and four other yes/no potential indicators of geriatric depression. Classification agreement and ROC curve analysis for the full and 15-item GDS scale scores were calculated. Individual item hit rates for MINI criterion were calculated for GDS items and four new items.

Results: GDS and GDS-15 at standard cut points had 70–75% agreement with MINI. Best sensitivity and specificity were obtained at lower than standard cut points. Some GDS Withdrawal, Apathy, lack of Vigor (WAV) and cognitive items obtained very low hit rates. New items “I just don't feel like myself” and “I feel I am a burden to others” better discriminated MINI depression than most GDS items and had good item-to-total correlations with the GDS.

Conclusions: Diagnostic criteria and GDS screen had partial agreement. Some GDS items did not adequately represent depression among functionally impaired or oldest old older adults. Feeling one is a burden and the sense of feeling “different” from usual may be useful indicators of depression among vulnerable older adults.

Keywords

Geriatric Depression Scalesubthreshold depressionnon-major depressionminor depressionmeasurementassessment
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 6 , August 2011 , pp. 950 - 960
Copyright
Copyright © International Psychogeriatric Association 2011

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References

Adams, K. B. (2001). Depressive symptoms, depletion, or developmental change? Withdrawal, apathy, and lack of vigor in the Geriatric Depression Scale. The Gerontologist, 41, 768–777.CrossRefGoogle ScholarPubMed
Adams, K. B. and Moon, H. (2009). Characteristics and risk factors of subthreshold depression in vulnerable elders. Aging and Mental Health, 13, 682–692.CrossRefGoogle ScholarPubMed
Adams, K. B. and Roberts, A. R. (2010). Reported coping strategies and depressive symptoms among African American and white residents of congregate housing. Journal of Gerontological Social Work, 53, 473–494.CrossRefGoogle ScholarPubMed
Adams, K. B., Matto, H. C. and Sanders, S. (2004). A Confirmatory Factor Analysis of the Geriatric Depression Scale. The Gerontologist, 44, 818–826.CrossRefGoogle ScholarPubMed
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). Washington, DC: American Psychiatric Association.Google Scholar
Blank, K., Gruman, C. and Robison, J. T. (2004). Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings. Journal or Gerontology: Medical Sciences, 59A, 378–384.Google Scholar
Blazer, D. G. (2003). Depression in late life: review and commentary. Journal of Gerontology: Medical Sciences, 58A, 249–265.Google Scholar
Brink, T. L., Yesavage, J. A., Lum, O., Heersema, P. H., Adey, M. and Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 37–43.CrossRefGoogle Scholar
Chachamovich, E., Fleck, M., Laidlaw, K. and Power, M. (2008). Impact of major depression and subsyndromal symptoms on quality of life and attitudes towards aging in an international sample of older adults. The Gerontologist, 48, 593–602.CrossRefGoogle Scholar
Charney, D. S. et al. (2003). Depression and bipolar support alliance consensus statement on the unmet needs in diagnosis and treatment of mood disorders in late life. Archives of General Psychiatry, 60, 664–672.CrossRefGoogle ScholarPubMed
Chodosh, J., Buckwalter, J. G., Blazer, D. G. and Seeman, T. E. (2004). How the question is asked makes a difference in the assessment of depressive symptoms in older persons. American Journal of Geriatric Psychiatry, 12, 75–83.CrossRefGoogle ScholarPubMed
Chopra, M. P. et al. (2005). Importance of sybsyndromal symptoms of depression in elderly patients. American Journal of Geriatric Psychiatry, 13, 597–606.CrossRefGoogle ScholarPubMed
Debruyne, H., van Buggenhout, M., LeBastard, N., Aries, M., Audenaert, K., DeDeyn, P. P. and Engelborghs, S. (2009). Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? International Journal of Geriatric Psychiatry, 24, 554–562.CrossRefGoogle Scholar
Gallo, J. J. and Rabins, P. V. (1999). Depression without sadness: alternative presentations of depression in late life. American Family Physician, 60, 820–826.Google ScholarPubMed
Gallo, J. J., Anthony, J. D. and Muthen, B. O. (1994). Age differences in the symptoms of depression: a latent trait analysis. Journals of Gerontology: Psychological Sciences, 49, P251–P264.CrossRefGoogle ScholarPubMed
Gallo, J. J., Rabins, P. V., Lyketsos, C. G., Tien, A. Y. and Anthony, J. C. (1997). Depression without sadness: functional outcomes of nondysphoric depression in later life. Journal of the American Geriatrics Society, 45, 570–578.CrossRefGoogle ScholarPubMed
Haringsma, R., Engels, G. I., Beekman, A. T. F., and Spinhoven, P. (2004). The criterion validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a sample of self-referred elders with depressive symptomatology. International Journal of Geriatric Psychiatry, 19, 558–563.CrossRefGoogle Scholar
Holland, J. M. (2010). The structure of late-life depressive symptoms across a 20-year span: a taxometric investigation. Psychology and Aging, 25, 142–156.CrossRefGoogle Scholar
Horowitz, A., Reinhardt, J. P. and Kennedy, G. J. (2005). Major and subthreshold depression among older adults seeking vision rehabilitation services. American Journal of Geriatric Psychiatry, 13, 180–187.CrossRefGoogle ScholarPubMed
Hybels, C. F., Pieper, C. F., Blazer, D. G. and Steffens, D. C. (2008). The course of depressive symptoms in older adults with comorbid major depression and dysthymia. American Journal of Geriatric Psychiatry, 16, 300–309.CrossRefGoogle ScholarPubMed
Judd, L. L., Akiskal, H. S. and Paulus, M. P. (1997). The role and clinical significance of sybsyndromal depressive symptoms (SSD) in uniolar major depressive disorder. Journal of Affective Disorders, 45, 5–18.CrossRefGoogle ScholarPubMed
Judd, L. L. and Akiskal, H. S. (2002). The clinical and public health relevance of current research of subthreshold depressive symptoms to elderly patients. American Journal of Geriatric Psychiatry, 10, 233–238.CrossRefGoogle Scholar
King, D. A. and Markus, H. E. (2000). Mood disorders in older adults. In Whitbourne, S. and Whitbourne, (eds.), Psychopathology in Later Adulthood (pp.141–172). New York: Wiley and Sons.Google Scholar
Lavretsky, H. and Kumar, A. (2002). Clinically significant non-major depression: old concepts, new insights. American Journal of Geriatric Psychiatry, 10, 239–255.CrossRefGoogle ScholarPubMed
Lewinsohn, P. M., Rohde, P. and Crozier, L. C. (1991). Age and depression: unique and shared effects. Psychology and Aging, 6, 247–260.CrossRefGoogle ScholarPubMed
Lyness, J. M. (2008). Naturalistic outcomes of minor and subsyndromal depression in older primary care patients. International Journal of Geriatric Psychiatry, 23, 773–781.CrossRefGoogle ScholarPubMed
Lyness, J. M., King, D. A., Cox, C., Yoerdiono, Z. and Caine, E. (1999). The importance of subsyndromal depression in older primary care patients: prevalence and associated functional disability. Journal of the American Geriatrics Society, 47, 647–6.CrossRefGoogle ScholarPubMed
National Institute of Mental Health (2007). Older Adults: Depression and Suicide Facts. Available at: http://www.nimh.nih.gov/health/publications/older-adults-depression-and-suicide-facts.html; last accessed 13 November 2008.Google Scholar
Newmann, J. P. (1989). Aging and depression. Psychology and Aging, 4, 150–165.CrossRefGoogle ScholarPubMed
Newmann, J. P., Klein, M. H., Jensen, J. E. and Essex, M. J. (1996). Depressive symptom experience among older women: a comparison of alternative measurement approaches. Psychology and Aging, 11, 112–126.CrossRefGoogle ScholarPubMed
Norris, M. P. and Woehr, M. D. (1998). Differentiating somatic symptoms in the elderly: Depression, aging, or illness? Journal of Mental Health and Aging, 4, 347–359.Google Scholar
Norris, M. P., Arnau, R. C., Bramson, R. and Meagher, M. W. (2004). The efficacy of somatic symptoms in assessing depression in older primary care patients. Clinical Gerontologist, 27 (1/2), 43–57.CrossRefGoogle Scholar
Olfson, M., Broadhead, W. E., Weissman, M. M., Leon, A. C., Farber, L., Hoven, C. and Kathol, R. (1996). Subthreshold psychiatric symptoms in a primary care group practice. Archives of General Psychiatry, 53, 880–886.CrossRefGoogle Scholar
Peach, J., Koob, J. J. and Kraus, M. J. (2001). Psychometric evaluation of the Geriatric Depression Scale (GDS): supporting its use in health care settings. Clinical Gerontologist, 23 (3/4), 57–68.CrossRefGoogle Scholar
Rapaport, M. H. and Judd, L. L. (1998). Minor depressive disorder and subsyndromal depressive symptoms: functional impairment and response to treatment. Journal of Affective Disorders, 48, 227–232.CrossRefGoogle ScholarPubMed
Schreiner, A. S., Hayakawa, H., Morimoto, T. and Kakuma, T. (2003). Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in dementia among Japanese subjects. International Journal of Geriatric Psychiatry, 18, 498–505.CrossRefGoogle ScholarPubMed
Sheehan, D. V. et al. (1998). The Mini-International Neuropsychiatric Interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–33.Google ScholarPubMed
Sheehan, B., Bass, C., Briggs, R. and Jacoby, R. (2003). Somatic symptoms among older depressed primary care patients. International Journal of Geriatric Psychiatry, 18, 547–548.CrossRefGoogle ScholarPubMed
Sheikh, J. I. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. In Sheikh, J.I. and Yesavage, J.A. (eds.), Clinical Gerontology: A Guide to Assessment and Intervention Vol. 5. (pp. 165–173), New York: The Haworth Press.Google Scholar
Shvartzman, P., Weiner, Z., Vardy, D., Friger, M., Sherf, M. and Biderman, A. (2005). Health services utilization by depressive patients identified by the MINI questionnaire in a primary care setting. Scandinavian Journal of Primary Health Care, 23, 18–25.CrossRefGoogle Scholar
Watson, L. C. and Pignone, M. P. (2003). Screening accuracy for late-life depression in primary care: a systematic review. Journal of Family Practice, 52, 956–964.Google ScholarPubMed
Watson, L. C., Lewis, C. L., Kistler, C. E., Amick, H. R. and Boustani, M. (2004). Can we trust depression screening instruments in healthy ‘old-old’ adults? International Journal of Geriatric Psychiatry, 19, 278–285.CrossRefGoogle ScholarPubMed
Welsh, K. A., Breitner, J. C. S. and Magruderhabib, K. M. (1993). Detection of dementia in the elderly using Telephone Screening of Cognitive Status. Neuropsychiatry Neuropsychology and Behavioral Neurology, 6, 103–110.Google Scholar
Yesavage, J. A. et al. (1983). Development and validation of a Geriatric Depression Screening Scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49.CrossRefGoogle Scholar