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Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile.

ABSTRACT: BACKGROUND:There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities. OBJECTIVE:The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults. METHODS:Cross-sectional study with a sample of 800 older people, 71% of whom were self-declared indigenous (Aymara/Mapuche). RESULTS:The non-indigenous group had a higher total GDS-15 score and lower quality of life and wellbeing scores than the indigenous groups (p < 0.001). The GDS-15 had a KR-20 coefficient of 0.90 for the non-indigenous group, 0.80 for Aymara, and 0.85 for Mapuche. The homogeneity index was 0.38 for non-indigenous, 0.24 for Aymara, and 0.29 for Mapuche. DISCUSSION:The GDS-15 showed satisfactory psychometric characteristics for the samples studied. However, the better results observed for the non-indigenous group suggest that some characteristics and content of the rating scale are not fully appropriate for the indigenous older population. CONCLUSIONS:There is a need to develop the transcultural validation of scales such as GDS-15, which are applied in a standardized manner in geriatric evaluations as part of primary healthcare.

SUBMITTER: Gallardo-Peralta LP

PROVIDER: S-EPMC7237627 | biostudies-literature | 2020 May

REPOSITORIES: biostudies-literature

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Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile.

Gallardo-Peralta Lorena P LP Rodríguez-Blázquez Carmen C Ayala-García Alba A Forjaz María João MJ

Psicologia, reflexao e critica : revista semestral do Departamento de Psicologia da UFRGS 20200519 1

<h4>Background</h4>There has been scant research published regarding the assessment of depression in ethnic groups, and few studies have addressed the validation of scales for standardized assessment of depressive symptoms among indigenous minorities.<h4>Objective</h4>The aim of this study was to analyze the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15) for a multi-ethnic sample of older Chilean adults.<h4>Methods</h4>Cross-sectional study with a sample of 800 older ...[more]

PMID: 32430560

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Project description:IntroductionThe 30-item Geriatric Depression Scale (GDS-30) and the shorter GDS-15, GDS-5 and GDS-4 are recommended as depression screening tools for elderly individuals. Existing meta-analyses on the diagnostic accuracy of the GDS have not been able to conduct subgroup analyses, have included patients already identified as depressed who would not be screened in practice and have not accounted for possible bias due to selective reporting of results from only better-performing cut-offs in primary studies. Individual participant data meta-analysis (IPDMA), which involves a standard systematic review, then a synthesis of individual participant data, rather than summary results, could address these limitations. The objective of our IPDMA is to generate accuracy estimates to detect major depression for all possible cut-offs of each version of the GDS among studies using different reference standards, separately and among participant subgroups based on age, sex, dementia diagnosis and care settings. In addition, we will use a modelling approach to generate individual participant probabilities for major depression based on GDS scores (rather than a dichotomous cut-off) and participant characteristics (eg, sex, age, dementia status, care setting).Methods and analysisIndividual participant data comparing GDS scores to a major depression diagnosis based on a validated structured or semistructured diagnostic interview will be sought via a systematic review. Data sources will include Medline, Medline In-Process & Other Non-Indexed Citations, PsycINFO and Web of Science. Bivariate random-effects models will be used to estimate diagnostic accuracy parameters for each cut-off of the different versions of the GDS. Prespecified subgroup analyses will be conducted. Risk of bias will be assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool.Ethics and disseminationThe findings of this study will be of interest to stakeholders involved in research, clinical practice and policy.Prospero registration numberCRD42018104329.

Project description:BackgroundThe 15-item Geriatric Depression Scale (GDS-15) shows good performance in detecting depression among older persons, but its applicability has not been well studied in non-Western oldest-old adults and centenarians. This study aimed to evaluate the psychometric property of the GDS-15 and a simplified version among a large representative longevous population in China.MethodsA total of 1624 individuals (786 oldest-old persons aged from 80 to 99 years; 838 centenarians aged 100+ years) participated in this study. Home interviews with structured questionnaires were conducted to collect sociodemographic data. Depressive symptoms were measured using the Chinese GDS-15 version. We implemented mixed methods for the psychometric evaluation of the GDS-15. Cronbach's α coefficient and item-total correlation coefficients were used to evaluate the internal consistency. A standard expert consultation was conducted to test the content validity of each item. Multiple factor analyses were used to explore the optimal factor structure and measurement invariance.ResultsThe α coefficient of the GDS-15 was 0.745, while two items impaired the overall consistency reliability. Nineteen experts rated the applicability for each item and provided removal suggestion. Five items with less validity were removed, and a simplified 10-item GDS model with three-factor structure was proposed as an optimal solution. The GDS-10 model showed factorial equivalence across age, sex, residence, and education in multi-group confirmatory factor analyses.ConclusionsThe original GDS-15 has acceptable internal reliability, known-group validity, and concurrent validity among Chinese community-dwelling oldest-old and centenarians; however we provided preliminary evidence indicating that individual items related to somatic function or social activities may not be applicable for this population. The modified GDS-10 can be proposed as a potentially more practical and comprehensible instrument for depression screening.

Project description:BackgroundIn older patients with cancer, depression is difficult to assess because of its heterogeneous clinical expression. The 4-item version of the Geriatric Depression Scale (GDS-4) is quick and easy to administer but has not been validated in this population. The present study was designed to test the diagnostic performance of the GDS-4 in a French cohort of older patients with cancer before treatment.Materials and methodsOur cross-sectional analysis of data from the Elderly Cancer Patient cohort covered all patients with cancer aged ≥70 years and referred for geriatric assessment at two centers in France between 2007 and 2018. The GDS-4's psychometric properties were evaluated against three different measures of depression: the geriatrician's clinical diagnosis (based on a semistructured interview), the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, and a cluster analysis. The scale's sensitivity, specificity, positive and negative likelihood ratios, and area under the receiver operating characteristic curve (AUROC) were calculated.ResultsIn a sample of 2,293 patients (median age, 81 years; women, 46%), the GDS-4's sensitivity and specificity for detecting physician-diagnosed depression were, respectively, 90% and 89%. The positive and negative likelihood ratios were 8.2 and 0.11, and the AUROC was 92%. When considering the subset of patients with data on all measures of depression, the sensitivity and specificity values were, respectively, ≥90% and ≥72%, the positive and negative likelihood ratios were, respectively, ≥3.4 and ≤ 0.11, and the AUROC was ≥91%.ConclusionThe GDS-4 appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer.Implications for practiceConsidering the overlap between symptoms of cancer and symptoms of depression, depression is particularly difficult to assess in older geriatric oncology and is associated with poor outcomes; there is a need for a routine psychological screening. Self-report instruments like the 4-item version of the Geriatric Depression Scale appears to be a clinically relevant, easy-to-use tool for routine depression screening in older patients with cancer. Asking four questions might enable physicians to screen older patients with cancer for depression and then guide them toward further clinical evaluation and appropriate care if required.

Project description:BackgroundDepression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to identify the frequency of unrecognized geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS.MethodsThis was a cross-sectional study of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into "no", "mild-moderate" and "severe" depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviors were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach's alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman's correlation, receiver operating characteristic curve, and kappa coefficient.ResultsTwo hundred eighty patients were enrolled with an overall prevalence of unrecognized depression of 45.7% [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived "heart and mind" disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman's correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach's alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach's alpha to 0.623.ConclusionsUnrecognized geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.

Dataset Information

Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile.

Publications

Multi-ethnic validation of 15-item Geriatric Depression Scale in Chile.

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