Development and testing of a five-item version of the Geriatric Depression Scale.
OBJECTIVE
To develop and test the effectiveness of a 5-item version of the Geriatric Depression Scale (GDS) in screening for depression in a frail community-dwelling older population.


METHODS
A cross-sectional study.


METHODS
A geriatric outpatient clinic at the Sepulveda VA Medical Center, Sepulveda, California.


METHODS
A total of 74 frail outpatients (98.6% male, mean age 74.6) enrolled in an ongoing trial.


METHODS
Subjects had a comprehensive geriatric assessment that included a structured clinical evaluation for depression with geropsychiatric consultation. A 5-item version of the GDS was created from the 15-item GDS by selecting the items with the highest Pearson chi2 correlation with clinical diagnosis of depression. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for the 15-item GDS and the new 5-item scale.


RESULTS
Subjects had a mean GDS score of 6.2 (range 0-15). Clinical evaluation found that 46% of subjects were depressed. The depressed and not depressed groups were similar with regard to demographics, mental status, educational level, and number of chronic medical conditions. Using clinical evaluation as the gold standard for depression, the 5-item GDS (compared with the 15-item GDS results shown in parentheses) had a sensitivity of .97 (.94), specificity of .85 (.83), positive predictive value of .85 (.82), negative predictive value of .97 (.94), and accuracy of .90 (.88) for predicting depression. Significant agreement was found between depression diagnosis and the 5-item GDS (kappa = 0.81). Multiple other short forms were tested, and are discussed. The mean administration times for the 5- and 15-item GDS were .9 and 2.7 minutes, respectively.


CONCLUSIONS
The 5-item GDS was as effective as the 15-item GDS for depression screening in this population, with a marked reduction in administration time. If validated elsewhere, it may prove to be a preferred screening test for depression.
Geriatric Research, Education and Clinical Center, Veterans Administration Medical Center, Sepulveda, California 91343, USA.
M T
MT
Hoyl
C A
CA
Alessi
J O
JO
Harker
K R
KR
Josephson
F M
FM
Pietruszka
M
M
Koelfgen
J R
JR
Mervis
L J
LJ
Fitten
L Z
LZ
Rubenstein
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis*; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D016013:Likelihood Functions; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008603:Mental Health; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index