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Accuracy of the 15-item geriatric depression scale (GDS-15) in a community sample of the oldest old
Anton J M de Craen1, T J Heeren, Jacobijn Gussekloo
1Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands. craen@lumc.nl
Background:
Cognitive impairment is common in the oldest old. This might influence the sensitivity and specificity of the 15-item Geriatric Depression Scale (GDS-15). Few studies, however, have included subjects older than 85 years to evaluate the GDS-15 as a screening instrument for depression.
Objective:
To assess the sensitivity and specificity of the GDS-15 in a community sample of the oldest old.
Methods:
Seventy-nine subjects aged 85 and over were enrolled in the study. The GDS-15 and the Mini-Mental State Examination (MMSE) were administered by a trained interviewer. Within two days the Geriatric Mental State (GMS)/AGECAT, was administered to obtain a clinical diagnosis of depression.
Results:
Eight subjects (10%) were diagnosed with clinical depression. At a cut-off point of 3/4 the sensitivity and specificity of the GDS-15 were 88% and 76% respectively. In the group with MMSE scores of 28 and higher sensitivity was unaffected at all cut-off points while specificity increased. In the group with MMSE scores below 28 sensitivity was also unaffected at all cut-off points while specificity decreased.
Conclusion:
The GDS-15 is a suitable instrument to diagnose depression in the general population of the oldest old. The optimal cut-off point depends on its intended use. In subjects with cognitive impairment the accuracy should be investigated further.
