Ovid: Welcome to Ovid

Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment?.
Debruyne, Hans 1,5+; Buggenhout, Michael Van 2,3,4+; Bastard, Nathalie Le 2; Aries, Marcel 1; Audenaert, Kurt 5; Deyn, Peter Paul De 1,2,4,*,++; Engelborghs, Sebastiaan 1,2,3,4++
[Article] International Journal of Geriatric Psychiatry. 24(6):556-562, June 2009.

(Format: HTML, PDF)

Objective: To determine the reliability of the 30-item Geriatric Depression Scale (GDS-30) for the screening of depressive symptoms in dementia and mild cognitive impairment (MCI) using the Cornell Scale for Depression in Dementia (CSDD) as the 'gold standard'.

Methods: Diagnosed according to strictly applied clinical diagnostic criteria, patients with MCI (n=156) and probable Alzheimer's disease (AD) (n=247) were included. GDS-30, CSDD, Mini Mental State Examination (MMSE) and Global Deterioration Scale were assessed in all patients at inclusion. The AD group was divided in three subgroups: mild AD (MMSE>=18) (n=117), moderate AD (MMSE<18 and >=10) (n=89) and severe AD (MMSE<10) (n=38).

Results: In MCI patients, moderate but highly significant correlations were found between GDS-30 and CSDD scores (Pearson: r=0.565; p<0.001). In mildly (r=0.294; p=0.001), moderately (r=0.273; p=0.010) and severely (r=0.348; p=0.032) affected AD patients, only weak correlations between GDS-30 and CSDD scores were calculated. ROC curve analysis showed that sensitivity and specificity values of respectively 95% and 67% were achieved when a GDS-30 cut-off score of 8 was applied in MCI patients. In AD patients, too low sensitivity and specificity values did not allow selecting an optimal cut-off score by means of ROC curve analysis.

Conclusion: Using the CSDD as 'gold standard', we demonstrated that the GDS-30 is a reliable screening tool for depressive symptoms in MCI but not in AD patients. Copyright (C) 2009 John Wiley & Sons, Ltd.