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Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing

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A Collateral Source Version of the Geriatric Depression Rating Scale.

Rodney L Nitcher¹, William J Burke¹, William H Roccaforte¹

¹Creighton-Nebraska Department of Psychiatry, University of Nebraska Medical Center, Omaha, Nebraska.

The American Journal of Geriatric Psychiatry : Official Journal of the American Association for Geriatric Psychiatry

|May 23, 2017

Summary

Collateral sources identified more depression symptoms than patients. While the Geriatric Depression Scale (GDS) and its collateral source version (CS-GDS) showed good diagnostic agreement, the CS-GDS had limited specificity.

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Area of Science:

Geriatric Psychiatry
Psychometric Assessment
Clinical Diagnostics

Background:

Depression is common in older adults.
Accurate depression screening is crucial for geriatric patients.
Patient self-reports may not always capture the full clinical picture.

Purpose of the Study:

To evaluate the utility of a collateral source version of the Geriatric Depression Scale (CS-GDS) in assessing depression in geriatric patients.
To compare the diagnostic agreement between patient-completed GDS, CS-GDS, and psychiatric diagnoses.

Main Methods:

194 geriatric patients completed the GDS.
Collateral sources completed the CS-GDS for each patient.
Results were compared against blind, prospective diagnoses by geriatric psychiatrists.
Receiver operating characteristic (ROC) curve analyses were performed.

Main Results:

Collateral sources reported significantly more depression symptoms (28/30) than patients.
Good agreement was observed between clinical diagnoses and both GDS and CS-GDS.
The CS-GDS demonstrated limited specificity and poor positive predictive value at established GDS cutoff scores.

Conclusions:

The CS-GDS may capture more symptoms than patient self-reports in geriatric depression assessment.
Despite good overall agreement, the CS-GDS requires further validation for clinical diagnostic use due to specificity limitations.
Integrating collateral information can enhance geriatric depression screening but requires careful interpretation.