title: Instruments for screening for depression and dementia in a long-term care facility.
abstract: The high prevalence of mental disorders such as depression and dementia in institutionalized elderly patients warrants screening for psychiatric diagnosis in patients newly admitted to long-term care facilities. The diagnostic accuracy of the Mini-Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS) was evaluated against a standardized psychiatric interview. The MMSE was found to be 81% sensitive and 83% specific in screening for dementia using a previously established cutpoint of less than 24/30 points. Adjusting MMSE scores for physical disabilities precluding completion of specific tasks on the MMSE did not significantly change the diagnostic accuracy of the test. The GDS was 47% sensitive and 75% specific in screening for depression using the suggested cutpoint of greater than 13/30 points. The MMSE was significantly correlated with functional status (r = 0.48, P = .0001), but not with the scores on the GDS or the clinical diagnosis of depression. The GDS did not correlate with functional status. In summary, the MMSE is a good screening test for dementia in institutionalized elderly, but the GDS is not sensitive for depression in this population.
authors.affiliation: Department of Medicine, Johns Hopkins Hospital, Baltimore, MD 21205.
authors.forename: S
authors.initials: S
authors.lastname: Kafonek
authors.forename: W H
authors.initials: WH
authors.lastname: Ettinger
authors.forename: R
authors.initials: R
authors.lastname: Roca
authors.forename: S
authors.initials: S
authors.lastname: Kittner
authors.forename: N
authors.initials: N
authors.lastname: Taylor
authors.forename: P S
authors.initials: PS
authors.lastname: German
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003072:Cognition Disorders / Q000175:diagnosis; D003704:Dementia / Q000175:diagnosis*; D003863:Depression / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007326:Institutionalization; D008297:Male; D008609:Mental Status Schedule; D011581:Psychological Tests; D012680:Sensitivity and Specificity; D012866:Skilled Nursing Facilities