Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0046
Trends in Psychiatry and Psychotherapy
Brief Communication

Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community-dwelling oldest-old sample: the Pietà Study

Acurácia da versão de 15 itens da Escala de Depressão Geriátrica (GDS-15) em uma amostra de idosos muito-idosos residentes na comunidade: Estudo Pietà

Filipi Leles da Costa Dias; Antônio Lúcio Teixeira; Henrique Cerqueira Guimarães; Maira Tonidandel Barbosa; Elisa de Paula França Resende; Rogério Gomes Beato; Karoline Carvalho Carmona; Paulo Caramelli

http://dx.doi.org/10.1590/2237-6089-2017-0046 Trends Psychiatry Psychother, vol.39, n4, p.276-279, 2017
PDF
SciELO
Downloads: 0
Views: 361

Abstract

Abstract Introduction Late-life depression (LLD) is common, but remains underdiagnosed. Validated screening tools for use with the oldest-old in clinical practice are still lacking, particularly in developing countries. Objectives To evaluate the accuracy of a screening tool for LLD in a community-dwelling oldest-old sample. Methods We evaluated 457 community-dwelling elderly subjects, aged ≥75 years and without dementia, with the Geriatric Depression Scale (GDS-15). Depression diagnosis was established according to DSM-IV criteria following a structured psychiatric interview with the Mini International Neuropsychiatric Interview (MINI). Results Fifty-two individuals (11.4%) were diagnosed with major depression. The area under the receiver operating characteristic (ROC) curve was 0.908 (p<0.001). Using a cut-off score of 5/6 (not depressed/depressed), 84 (18.4%) subjects were considered depressed by the GDS-15 (kappa coefficient = 53.8%, p<0.001). The 4/5 cut-off point achieved the best combination of sensitivity (86.5%) and specificity (82.7%) (Youden's index = 0.692), with robust negative (0.9802) and reasonable positive predictive values (0.3819). Conclusion GDS-15 showed good accuracy as a screening tool for major depression in this community-based sample of low-educated oldest-old individuals. Our findings support the use of the 4/5 cut-off score, which showed the best diagnostic capacity.

Keywords

Depression, geriatric psychiatry, geriatric assessment

Resumo

Resumo Introdução A depressão geriátrica (DG) é um transtorno prevalente que permanece sendo subdiagnosticado. Ferramentas validadas para rastreio de DG em idosos muito idosos na prática clínica são necessárias, especialmente em países em desenvolvimento. Objetivos Avaliar a acurácia diagnóstica da Escala de Depressão Geriátrica (Geriatric Depression Scale, GDS-15) em uma população de idosos muito idosos residentes na comunidade. Métodos Foram avaliados, com a GDS-15, 457 indivíduos nãodemenciados, residentes na comunidade, com idade ≥75 anos. O diagnóstico definitivo de depressão maior foi realizado através da entrevista semiestruturada Mini International Neuropsychiatric Interview (MINI), de acordo com os critérios do DSM-IV. Resultados Cinquenta e dois indivíduos (11,4%) foram diagnosticados com episódio depressivo maior. A área sob a curva receiver operating characteristic (ROC) foi de 0,908 (p<0,001). Utilizando-se o ponto de corte 5/6 (não-deprimido/deprimido), 84 (18,4%) indivíduos foram considerados deprimidos pela GDS-15 (coeficiente de kappa = 53,8%, p<0,001). O ponto de corte 4/5 atingiu a melhor combinação entre sensibilidade (86,5%) e especificidade (82,7%) (índice de Youden = 0,692), com valor preditivo negativo robusto (0,9802) e razoável valor preditivo positivo (0,3819). Conclusão A GDS-15 demonstrou boa acurácia para o rastreio de depressão maior nesta amostra de base populacional de idosos muito idosos com baixa escolaridade. Os resultados do presente estudo indicam que o ponto de corte 4/5 mostrou-se mais adequado para utilização nesta população.

Palavras-chave

Depressão, psiquiatria geriátrica, avaliação geriátrica

References

World population ageing 2015 - Highlights. 2015.

Luppa M, Sikorski C, Luck T, Ehreke L, Konnopka A, Wiese B. Age- and gender-specific prevalence of depression in latest-life-systematic review and meta-analysis. J Affect Disord. 2012;136:212-21.

Wilkins CH, Mathews J, Sheline YI. Late life depression with cognitive impairment: evaluation and treatment. Clin Interv Aging. 2009;4:51-7.

Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982;17:37-49.

Almeida OP, Almeida SA. Reliability of the Brazilian version of the abbreviated form of Geriatric Depression Scale (GDS) short form. Arq Neuropsiquiatr. 1999;57:421-6.

Caramelli P, Barbosa MT, Sakurai E, Dos Santos EL, Beato RG, Machado JC. The Pieta Study: epidemiological investigation on successful brain aging in Caete (MG), Brazil. Methods and baseline cohort characteristics. Arq Neuropsiquiatr. 2011;69:579-84.

Amorim P. Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Rev Bras Psiquiatr. 2000;22:106-15.

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12:189-98.

Nitrini R, Lefevre BH, Mathias SC, Caramelli P, Carrilho PE, Sauaia N. Neuropsychological tests of simple application for diagnosing dementia. Arq Neuropsiquiatr. 1994;52:457-65.

Castro S, Damin AE, Porto SC, Caramelli P, Nitirini R. The abbreviated form of the Brief Cognitive Battery in the diagnosis of dementia in Alzheimer's disease. Dement Neuropsychol. 2009;3:327-31.

Nitrini R, Caramelli P, Herrera Junior E, Porto CS, Charchat-Fichman H, Carthery MT. Performance of illiterate and literate nondemented elderly subjects in two tests of long-term memory. J Int Neuropsychol Soc. 2004;10:634-8.

Sclan SG, Reisberg B. Functional assessment staging (FAST) in Alzheimer's disease: reliability, validity, and ordinality. Int Psychogeriatr. 1992;4(^sSuppl 1):55-69.

Pfeffer RI, Kurosaki TT, Harrah Jr. CH, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol. 1982;37:323-9.

Craen AJ de, Heeren TJ, Gussekloo J. Accuracy of the 15-item Geriatric Depression Scale (GDS-15) in a community sample of the oldest old. Int J Geriatr Psychiatry. 2003;18:63-6.

Marc LG, Raue PJ, Bruce ML. Screening performance of the 15-item Geriatric Depression Scale in a diverse elderly home care population. Am J Geriatr Psychiatry. 2008;16:914-21.

Beekman AT, Copeland JR, Prince MJ. Review of community prevalence of depression in later life. Br J Psychiatry. 1999;174:307-11.

6169de3ca953955b057a81a2 trends Articles
Links & Downloads
2238-0019 (Electronic)
Trends Psychiatry Psychother ©2024 All rights reserved.

Trends Psychiatry Psychother

Share this page
Page Sections