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Related Experiment Videos

Validating the GDS depression screen in the nursing home

S A McGivney1, M Mulvihill, B Taylor

  • 1Lenox Hill Medical Center, New York, New York.

Journal of the American Geriatrics Society
|May 1, 1994
PubMed
Summary

The Geriatric Depression Scale (GDS) is more accurate for nursing home residents with Mini-Mental Status Exam (MMSE) scores of 15 or higher. This two-step approach improves depression detection in this population.

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Area of Science:

  • Geriatric Psychiatry
  • Clinical Psychology
  • Long-term Care Research

Background:

  • The Geriatric Depression Scale (GDS) is validated for ambulatory elderly but less effective in nursing home (NH) populations due to cognitive impairment.
  • Accurate depression screening is crucial in NH residents, a group often experiencing underdiagnosed depression.

Purpose of the Study:

  • To determine the minimum Mini-Mental Status Exam (MMSE) score threshold for maintaining the validity of the Geriatric Depression Scale (GDS) in nursing home residents.
  • To enhance the utility of the GDS for detecting depression in cognitively impaired elderly individuals residing in nursing homes.

Main Methods:

  • A validation study was conducted in New York City nursing homes.
  • 66 newly admitted residents completed psychiatric assessments, the MMSE, and the GDS.

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  • The GDS's validity was assessed against psychiatric diagnoses at decreasing MMSE score levels, using a GDS cutoff of 10 or greater for depression.

    • Main Results:

    • Overall, the GDS showed 63% sensitivity and 83% specificity among all 66 participants.
    • When restricted to participants with an MMSE score of 15 or higher (n=44), sensitivity increased to 84% and specificity to 91%.
    • An MMSE score cutoff of 15 emerged as the optimal threshold for GDS validity.

    Conclusions:

    • A two-step diagnostic procedure—initially screening with MMSE (score ≥15) followed by the GDS—significantly improves the detection of depression in NH residents.
    • This refined approach enhances the diagnostic utility of the GDS, addressing the underdetection of depression in this vulnerable population.