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Screening for depression in elderly hemodialysis patients
Rasheed A Balogun1, Faruk Turgut, Seki A Balogun
1Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA. rb8mh@virginia.edu
Nephron. Clinical Practice
|December 15, 2010
Summary
The Geriatric Depression Scale-15 (GDS-15) effectively screens for depression in elderly hemodialysis patients. This study validates the GDS-15 against a gold standard psychiatric interview, showing its utility in this vulnerable population.
Area of Science:
- Nephrology
- Geriatrics
- Psychiatry
Background:
- Depression is prevalent in elderly hemodialysis patients (≥65 years), increasing morbidity and mortality.
- Screening tools like the Beck's Depression Inventory (BDI) and Geriatric Depression Scale (GDS) are used, but their applicability varies across patient groups.
Purpose of the Study:
- To evaluate the 15-item Geriatric Depression Scale (GDS-15) for depression screening in elderly hemodialysis patients.
- To compare the diagnostic accuracy of the GDS-15 with the BDI in this specific population.
Main Methods:
- A cross-sectional study was conducted across four outpatient hemodialysis units.
- Elderly hemodialysis patients (≥65 years) were administered both the GDS-15 and BDI.
- A blinded geriatric psychiatrist conducted a gold standard psychiatric interview for diagnostic comparison (n=62).
Main Results:
- Both GDS-15 and BDI scores were significantly higher in depressed patients (p < 0.01).
- Receiver Operating Characteristic (ROC) curves indicated high predictive accuracy for GDS-15 (AUC: 0.808) and BDI (AUC: 0.729).
- Optimal cutoffs were GDS-15=5 (Sensitivity: 63%, Specificity: 82%) and BDI=10 (Sensitivity: 68%, Specificity: 77%).
Conclusions:
- The GDS-15 demonstrates validity as a screening tool for depression in elderly hemodialysis patients.
- The GDS-15 is a reliable alternative for assessing depression in this population compared to the BDI.
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