Accuracy of the 15-item geriatric depression scale (GDS-15) in a community sample of the oldest old.
BACKGROUND
Cognitive impairment is common in the oldest old. This might influence the sensitivity and specificity of the 15-item Geriatric Depression Scale (GDS-15). Few studies, however, have included subjects older than 85 years to evaluate the GDS-15 as a screening instrument for depression.


OBJECTIVE
To assess the sensitivity and specificity of the GDS-15 in a community sample of the oldest old.


METHODS
Seventy-nine subjects aged 85 and over were enrolled in the study. The GDS-15 and the Mini-Mental State Examination (MMSE) were administered by a trained interviewer. Within two days the Geriatric Mental State (GMS)/AGECAT, was administered to obtain a clinical diagnosis of depression.


RESULTS
Eight subjects (10%) were diagnosed with clinical depression. At a cut-off point of 3/4 the sensitivity and specificity of the GDS-15 were 88% and 76% respectively. In the group with MMSE scores of 28 and higher sensitivity was unaffected at all cut-off points while specificity increased. In the group with MMSE scores below 28 sensitivity was also unaffected at all cut-off points while specificity decreased.


CONCLUSIONS
The GDS-15 is a suitable instrument to diagnose depression in the general population of the oldest old. The optimal cut-off point depends on its intended use. In subjects with cognitive impairment the accuracy should be investigated further.
de Craen
Anton J M
AJ
Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands. craen@lumc.nl
Heeren
T J
TJ
Gussekloo
Jacobijn
J
D000368:Aged; D000369:Aged, 80 and over / Q000523:psychology*; D003072:Cognition Disorders / Q000150:complications; D003156:Community Mental Health Services / Q000379:methods; D003866:Depressive Disorder / Q000150:complications / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D011569:Psychiatric Status Rating Scales; D012680:Sensitivity and Specificity