The 15-item geriatric depression scale (GDS-15) demonstrated high discriminating ability between depressive and nondepressive states in a cohort of community-dwelling elderly individuals, according to study data published in the Journal of Affective Disorders.
Investigators abstracted data from the Ansan Geriatric Study (AGE), a cohort study of psychiatric disease and cognitive function among the elderly in South Korea. Per the AGE protocol, 1391 community-dwelling elderly individuals aged ≥60 years underwent structured clinical diagnostic interviews. Major and minor depressive disorder were diagnosed according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM IV). Demographic and clinical information were captured through interviews and self-report questionnaires. In addition to the GDS-15, patients were administered the Patient Health Questionnaire-9 and the Beck Depression Inventory as comparison diagnostic tools. Multicategory receiver operating characteristic (ROC) surfaces were evaluated; area under the curve (AUC) was used to determine the ability of the GDS-15 to discriminate between nondepressive states, minor depressive disorder, and major depressive disorder. The optimal cutoff points for diagnosis were determined based on the volume under the ROC surface (VUS) and the Youden index.
A total of 774 patients were enrolled in the study; 650 were classified as normal, 94 had minor depressive disorder, and 30 had major depressive disorder. The mean (standard deviation [SD]) patient age was 69.12 (4.93) years, and 59.8% were women. The mean GDS-15 score was 3.63 (3.48). For GDS-15, the AUC for the major depressive disorder group vs the combined normal and minor depressive disorder group was 0.93 (95% CI, 0.88-0.98). The AUC for the minor depressive disorder group vs the normal group was 0.89 (95% CI, 0.85-0.92). Per multicategory ROC surface analysis, the VUS for GDS-15 was 0.64 (95% CI, 0.55-0.73); the Youden index was 0.49 (95% CI, 0.42-0.56). The VUS values for the Patient Health Questionnaire-9 and the Beck Depression Inventory were not greater than the VUS of the GDS-15, suggesting that the discriminatory ability of GDS-15 was not lower than the other clinical measures of depression. The optimal cutoff points of GDS-15 were 4 and 11 points under the VUS and 5 and 10 points under the Youden index for minor and major depressive disorder, respectively. The overall classification accuracy based on the Youden index (78.7%) was higher than that based on the VUS (69.7%).
These data suggest that the GDS-15 may be a useful tool for identifying depression in the elderly. Results must be extrapolated with care, however, given the relatively small number of participants with depression compared with controls without depression. The investigators advise that the GDS-15 warrants further study as a potential diagnostic tool for major and minor depressive disorder.
Shin C, Park MH, Lee SH, et al. Usefulness of the 15-item geriatric depression scale (GDS-15) for classifying minor and major depressive disorders among community-dwelling elders [published online August 20, 2019]. J Affect Disord. doi:10.1016/j.jad.2019.08.053