title: Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults.
abstract: BACKGROUND
  Few studies have evaluated the validation of 15-item Geriatric Depression Scale (GDS-15) in a heterogeneous population with different age, ethnicity and comorbidities of elderly users of social services in the community.
  
  
  OBJECTIVE
  To assess the criterion validity and reliability of the GDS-15 and its equivalence across different gender, age groups, ethnicity and different comorbidities in community living elderly and nursing homes residents.
  
  
  METHODS
  A validation sample of non-demented 4253 elderly (age > or = 60 years), who regularly use community based care corner, senior activity center, day care center, sheltered homes and nursing homes were interviewed using the GDS-15. Structured clinical interview (SCID) was used to make DSM-IV diagnosis of major depressive disorder (MDD).
  
  
  RESULTS
  The overall sensitivity and specificity were 0.97 and 0.95, respectively (area under curve, AUC was 0.98). The overall Cronbach's alpha was 0.80, and intraclass coefficient of test--retest reliability over 2 weeks was 0.83 and inter-rater reliability was 0.94 (intra-class) and 0.99 (Cohen's kappa). Although some items in the GDS-15 appeared to be biased by gender, age and ethnicity, there were no clinically significant differences in test performance among different age, gender, ethnicity and comorbidities at cutoff of 4/5.
  
  
  CONCLUSIONS
  The GDS-15 was a reliable and valid screening for MDD across different age, gender, ethnicity and chronic illness status in the community and social service setting.
authors.affiliation: Department of Psychological Medicine, National University of Singapore, National University Hospital, 119074 Singapore.
authors.forename: Ma Shwe Zin
authors.initials: MS
authors.lastname: Nyunt
authors.forename: Calvin
authors.initials: C
authors.lastname: Fones
authors.forename: Mathew
authors.initials: M
authors.lastname: Niti
authors.forename: Tze-Pin
authors.initials: TP
authors.lastname: Ng
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D007406:Interview, Psychological / Q000379:methods*; D008297:Male; D008403:Mass Screening / Q000379:methods; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012372:ROC Curve; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires