Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patientswith cognitive impairment
Keywords
dementia • depression • Alzheimer's disease • Mild Cognitive Impairment • Geriatric Depression Scale • Cornell Scale for Depression in Dementia
Objective
This study aims tdetermine the reliability of the 30-item Geriatric Depression Scale (GDS-30) for the screening of depressive symptoms in dementia and mild cognitive impairment (MCI) using the Cornell Scale for Depression in Dementia (CSDD) as the gold standard.
Methods
Diagnosed according to strictly applied clinical diagnostic criteria, patients with MCI (n = 156) and probable Alzheimer's disease (AD) (n = 247) were included. GDS-30, CSDD, Mini Mental State Examination (MMSE) and Global Deterioration Scale were assessed in all patients at inclusion. The AD group was divided in three subgroups: mild AD (MMSE18) (n = 117), moderate AD (MMSE< 18 and 10) (n = 89) and severe AD (MMSE<10) (n = 38).
Results
In MCI patients, moderate but highly significant correlations were found between GDS-30 and CSDD scores (Pearson: r = 0.565; p < 0.001). In mildly (r = 0.294; p = 0.001), moderately (r = 0.273; p = 0.010) and severely (r = 0.348; p = 0.032) affected AD patients, only weak correlations between GDS-30 and CSDD scores were calculated. ROC curve analysis showed that sensitivity and specificity values of respectively 95% and 67% were achieved when a GDS-30 cut-off score of 8 was applied in MCI patients. In AD patients, too low sensitivity and specificity values did not allow selecting an optimal cut-off score by means of ROC curve analysis.
Conclusion
Using the CSDD as gold standard, we demonstrated that the GDS-30 is a reliable screening tool for depressive symptoms in MCI but not in AD patients. Copyright © 2009 John Wiley & Sons, Ltd.
*Correspondence to Peter Paul De Deyn, Laboratory of Neurochemistry and Behaviour, Institute Born-Bunge, University of Antwerp, Universiteitsplein 1, 2610 Antwerp, Belgium.
Hans Debruyne and Michael Van Buggenhout are joint first authors.
Peter Paul De Deyn and Sebastiaan Engelborghs are joint last authors.Email: Peter Paul De Deyn (peter.dedeyn@ua.ac.be)
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