title: Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study.
abstract: BACKGROUND
  The objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents.
  
  
  METHODS
  The data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata.
  
  
  RESULTS
  The GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment.
  
  
  CONCLUSIONS
  The MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression.
authors.affiliation: New Hanover Regional Medical Center, 2131 S 17th Street, Wilmington, NC 28401, USA. mdohrer@hotmail.com <mdohrer@hotmail.com>
authors.forename: Melissa
authors.initials: M
authors.lastname: Koehler
authors.forename: Terry
authors.initials: T
authors.lastname: Rabinowitz
authors.forename: John
authors.initials: J
authors.lastname: Hirdes
authors.forename: Michael
authors.initials: M
authors.lastname: Stones
authors.forename: G Iain
authors.initials: GI
authors.lastname: Carpenter
authors.forename: Brant E
authors.initials: BE
authors.lastname: Fries
authors.forename: John N
authors.initials: JN
authors.lastname: Morris
authors.forename: Richard N
authors.initials: RN
authors.lastname: Jones
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications; D003863:Depression / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011581:Psychological Tests; D011594:Psychometrics; D011795:Surveys and Questionnaires