title: Validity of the geriatric depression scale and the collateral source version of the geriatric depression scale in nursing homes.
abstract: BACKGROUND
  Depression is a common psychiatric disorder in older people. The study aimed to examine the screening accuracy of the Geriatric Depression Scale (GDS) and the Collateral Source version of the Geriatric Depression Scale (CS-GDS) in the nursing home setting.
  
  
  METHODS
  Eighty-eight residents from 14 nursing homes were assessed for depression using the GDS and the CS-GDS, and validated against clinician diagnosed depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders (SCID) for residents without dementia and the Provisional Diagnostic Criteria for Depression in Alzheimer Disease (PDCdAD) for those with dementia. The screening performances of five versions of the GDS (30-, 15-, 10-, 8-, and 4-item) and two versions of the CS-GDS (30- and 15-item) were analyzed using receiver operating characteristic (ROC) curves.
  
  
  RESULTS
  Among residents without dementia, both the self-rated (AUC = 0.75-0.79) and proxy-rated (AUC = 0.67) GDS variations performed significantly better than chance in screening for depression. However, neither instrument adequately identified depression among residents with dementia (AUC between 0.57 and 0.70). Among the GDS variations, the 4- and 8-item scales had the highest AUC and the optimal cut-offs were >0 and >3, respectively.
  
  
  CONCLUSIONS
  The validity of the GDS in detecting depression requires a certain level of cognitive functioning. While the CS-GDS is designed to remedy this issue by using an informant, it did not have adequate validity in detecting depression among residents with dementia. Further research is needed on informant selection and other factors that can potentially influence the validity of proxy-based measures in the nursing home setting.
authors.affiliation: Sydney Nursing School,The University of Sydney,Sydney,Australia.
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Li
authors.affiliation: Sydney Nursing School,The University of Sydney,Sydney,Australia.
authors.forename: Yun-Hee
authors.initials: YH
authors.lastname: Jeon
authors.affiliation: Faculty of Health Sciences,The University of Sydney,Sydney,Australia.
authors.forename: Lee-Fay
authors.initials: LF
authors.lastname: Low
authors.affiliation: Faculty of Health,University of Technology Sydney,Sydney,Australia.
authors.forename: Lynn
authors.initials: L
authors.lastname: Chenoweth
authors.affiliation: Monash Ageing Research Centre,Monash University,Melbourne,Australia.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: O'Connor
authors.affiliation: School of Nursing,Queensland University of Technology,Brisbane,Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Beattie
authors.affiliation: Centre for Healthy Brain Ageing,UNSW Australia,Sydney,Australia.
authors.forename: Henry
authors.initials: H
authors.lastname: Brodaty
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003704:Dementia / Q000150:complications*; D003863:Depression / Q000175:diagnosis*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012372:ROC Curve
keywords: assessment; depression; geriatric depression scale; nursing homes