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Published on: January 24, 2020
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Screening Tests for Depression in Older Black vs. White Patients
F M Baker1, Susan A Velli1, Juli Friedman1
1Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD.
Summary
The Center for Epidemiologic Studies-Depression Scale (CES-D) is more effective than the Geriatric Depression Scale (GDS) for identifying depression in older adults. This finding is particularly relevant for older Black and White patients, highlighting potential disparities in screening tool accuracy.
Area of Science:
- Geriatric Psychiatry
- Mental Health Screening
- Health Disparities in Older Adults
Background:
- Depression is a significant concern in older adults, impacting quality of life and increasing healthcare utilization.
- Accurate screening for depression is crucial for timely intervention and effective treatment in elderly populations.
- Existing screening instruments may exhibit differential performance across racial and ethnic groups.
Purpose of the Study:
- To evaluate the reliability and comparative effectiveness of two depression screening instruments, the CES-D and GDS, in older psychiatric patients.
- To assess the sensitivity of the CES-D and GDS in identifying depression among Black and White older adults.
- To determine if demographic factors, specifically race, influence the accuracy of these depression screening tools.
Main Methods:
- A cohort of 39 older psychiatric patients (age 50+) with confirmed depression diagnoses (SCID) participated.
- The Center for Epidemiologic Studies-Depression Scale (CES-D) and the Geriatric Depression Scale (GDS) were administered.
- Sensitivity analyses were conducted, comparing instrument performance between Black and White patient subgroups.
Main Results:
- The CES-D demonstrated higher sensitivity (71% in Black patients, 85% in White patients) compared to the GDS (53% in Black patients, 65% in White patients).
- The CES-D significantly outperformed the GDS in identifying depressive symptoms within this sample of older adults.
- Findings suggest potential differences in the effectiveness of CES-D and GDS for identifying depression in older Black versus White patients.
Conclusions:
- The CES-D appears to be a more sensitive screening tool for depression in older adults compared to the GDS in this study.
- The effectiveness of both CES-D and GDS may vary significantly across racial groups, indicating a need for culturally sensitive assessment.
- Further research with larger, diverse samples is warranted to validate these findings and inform clinical practice for older adults.
