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Ileri I, Eren F, Neselioglu S, Hafızoglu M, Karaduman D, Atbas C, Sahiner Z, Dikmeer A, Balcı C, Dogu BB, Cankurtaran M, Erel O, Halil MG. The role of thiol-disulfide homeostasis and ischemia-modified albumin in osteosarcopenia. Ir J Med Sci 2024; 193:2109-2114. [PMID: 38512402 DOI: 10.1007/s11845-024-03667-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 03/12/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Oxidative stress results from an imbalance between the induction of reactive oxygen species and the ability of cells to metabolize them. Numerous markers can be used to assess the level of oxidative stress. Thiol-disulfide homeostasis (TDH) and ischemia-modified albumin (IMA) are some of them. The aim of this study is to investigate the role of TDH and IMA, which are indicators of oxidative stress, in older patients with osteosarcopenia (OS). METHODS The study was conducted cross-sectionally in a geriatrics outpatient clinic. Patients who applied to the outpatient clinic for three months were included in the study. Patients with acute infection, delirium, malignancy, severe liver, heart or kidney dysfunction and who did not give their consent for the study were excluded from the study. The study was conducted with 136 patients. Sarcopenia was diagnosed according to muscle ultrasonography (USG) and handgrip strength (HGS) results. Osteopenia/osteoporosis was diagnosed according to bone mineral densitometry (BMD) results. The combination of osteopenia/osteoporosis and sarcopenia was accepted as OS. RESULTS Native thiol, total thiol value and nativethiol /totalthiol*100 values were significantly lower in the group with OS (respectively; value = 265 ± 53.8 standard deviation (SD) μmol/L, p = ≤ 0.001; value = 295.33 ± 55.77 SD μmol/L, p = 0.001; value = 90.06 (2.8) interquartile ranges (IQR), p = 0.033). Disulfide/native thiol*100 and disulfide/total thiol*100 values were significantly higher in the group with OS (respectively; value = 5.5 (1.7) IQR, p = 0.033; value = 4.97 (1.4) IQR, p = 0.034). CONCLUSION In our study, the role of oxidative stress in OS was demonstrated by using TDH as an oxidative stress parameter.
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Affiliation(s)
- Ibrahim Ileri
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Funda Eren
- Department of Clinical Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Salim Neselioglu
- Department of Clinical Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Merve Hafızoglu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Didem Karaduman
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Cansu Atbas
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Zeynep Sahiner
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ayse Dikmeer
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Cafer Balcı
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Burcu Balam Dogu
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
| | - Ozcan Erel
- Department of Clinical Biochemistry, Faculty of Medicine, Yıldırım Beyazit University, Ankara, Turkey
| | - Meltem Gülhan Halil
- Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey
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Honda H, Ashizawa R, Kameyama Y, Hirase T, Arizono S, Yoshimoto Y. Chronic pain in older adults with disabilities is associated with fall-related injuries: a prospective cohort study. Eur Geriatr Med 2024; 15:719-727. [PMID: 38512605 DOI: 10.1007/s41999-024-00965-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 02/19/2024] [Indexed: 03/23/2024]
Abstract
PURPOSE Previous studies have shown an association between chronic pain and the occurrence of falls in community-dwelling older adults; however, the association between chronic pain and fall-related injuries in older adults with disabilities is unclear. This study aimed to determine the association between chronic pain and fall-related injuries in older adults with disabilities. METHODS This 24-month prospective cohort study included older adults aged 65 years or older using Japanese long-term care insurance services. Chronic pain, defined as "pain that has persisted for more than three months to date," was assessed using a face-to-face questionnaire. Fall-related injuries, defined as "injuries requiring hospitalization or outpatient treatment due to a fall," were assessed using a fall calendar. Data were analyzed using a Cox proportional hazards model, with fall-related injury as the dependent variable, chronic pain as the independent variable, and confounders as covariates. RESULTS Among 133 included participants, 15 experienced fall-related injuries. After adjusting for age and sex as covariates, chronic pain was significantly associated with fall-related injuries (hazard ratio: 5.487, 95% confidence interval: 1.211-24.853, p = 0.027). CONCLUSIONS Chronic pain was associated with fall-related injuries in older adults with disabilities. In this population, a greater focus should be placed on treating chronic pain to reduce the occurrence of falls.
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Affiliation(s)
- Hiroya Honda
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, 3453 Mikatahara-cho, Kita-ku, Hamamatsu-shi, Shizuoka, 433-8558, Japan.
| | - Ryota Ashizawa
- Department of Rehabilitation, Seirei Mikatahara General Hospital, Hamamatsu, Japan
| | - Yuto Kameyama
- Division of Rehabilitation Science, Seirei Christopher University Graduate School, 3453 Mikatahara-cho, Kita-ku, Hamamatsu-shi, Shizuoka, 433-8558, Japan
| | - Tatsuya Hirase
- Division of Physical Therapy Science, Graduate Course of Health and Social Work, Kanagawa University of Human Services, Yokosuka, Japan
| | - Shinichi Arizono
- School of Rehabilitation Science, Seirei Christopher University, Hamamtsu, Japan
| | - Yoshinobu Yoshimoto
- School of Rehabilitation Science, Seirei Christopher University, Hamamtsu, Japan
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Edwards N, Walker S, Paddick SM, Prina AM, Chinnasamy M, Reddy N, Mboya IB, Mtei M, Varghese M, Nakkasuja N, Guerra M, Sapkota N, Dotchin C. Prevalence of depression and anxiety in older people in low- and middle- income countries in Africa, Asia and South America: A systematic review and meta-analysis. J Affect Disord 2023; 325:656-674. [PMID: 36681304 DOI: 10.1016/j.jad.2023.01.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND There is rapid growth of older people in Low- and Middle- Income Countries (LMICs). The aim of this review was to assess the literature on prevalence of anxiety and depression in this demographic, which to our knowledge, has not yet been conducted. METHODS Databases including Medline, PsychInfo, Embase, Scielo and African Journals Online were searched for terms including "mental disorders", "neurotic disorders", "mood disorders" and "anxiety disorders". Studies published between 1990 and 2020 providing data on older people (≥50 years) in LMICs (defined by World Bank Criteria) were included and quality-assessed. Meta-analysis was conducted on a subset of higher-quality studies to derive pooled prevalence estimates of depression. RESULTS One hundred and forty relevant studies were identified, of which thirty-two were included in meta-analysis. One hundred and fifteen studies reported depression prevalence only, 19 reported both depression and anxiety, and six reported anxiety only. In all studies identified, depression prevalence ranged from 0.5 % to 62.7 %, and Generalised Anxiety Disorder prevalence ranged from 0.2 % to 32.2 %. The pooled prevalence of depression on meta-analysis was 10.5 % (95 % CI, 8.9 % - 11.2 %). Reported prevalence rates of depression were significantly different in studies using ICD-10 compared with DSM criteria, and between community and clinical settings. LIMITATIONS The search strategy contained bias towards English language papers and high income country (HIC) publications. There is significant heterogeneity within the meta-analysis. DISCUSSION A wide range of methodologies and clinical criteria are used in prevalence studies of depression and anxiety in older people. Studies using screening tools found higher prevalence rates; clinicians and researchers should ensure diagnosis is made with gold-standard clinical criteria. Meta-analysis data suggest that rates of depression are similar in older people in LMICs compared to HICs but mental healthcare resources are limited, suggesting a large potential treatment gap.
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Affiliation(s)
- N Edwards
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle-Upon-Tyne, UK.
| | - S Walker
- Translational and Clinical Research Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - S-M Paddick
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Population Health Sciences Institute, Newcastle University, Newcastle-Upon-Tyne, UK
| | - A M Prina
- Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M Chinnasamy
- Bradford Primary Care NHS Foundation Trust, Bradford, UK
| | - N Reddy
- Newcastle University, Newcastle-Upon-Tyne, UK
| | - I B Mboya
- Institute of Public Health, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Mtei
- Department of Epidemiology and Biostatistics, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - M Varghese
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Nakkasuja
- College of Health Sciences, Makerere University, Kampala, Uganda
| | - M Guerra
- Memory and Depression Centre, Cayetano Heredia Peruvian University, Peru
| | - N Sapkota
- B.P Koirala Institute of Health Sciences, Dhahran, Eastern Nepal, Nepal
| | - C Dotchin
- Department of Old Age Psychiatry, Gateshead Health NHS Foundation Trust, Tyne and Wear, UK; Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK
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Sleep quality and its associations with disease activity and quality of life in older patients with rheumatoid arthritis. Eur Geriatr Med 2023; 14:317-324. [PMID: 36635492 DOI: 10.1007/s41999-022-00739-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/24/2022] [Indexed: 01/13/2023]
Abstract
PURPOSE Sleep disturbance is among the most important geriatric syndromes, and its evaluation is part of the routine comprehensive geriatric assessment (CGA). Previous studies have demonstrated that older patients with rheumatoid arthritis (RA) have poorer sleep quality than younger control patients. However, there needs to be more data on the sleep quality of older patients with RA with age-matched controls. METHODS Totally 100 participants, 50 older RA patients classified according to the ACR criteria, and 50 age- and gender-matched control patients without RA were included in the study. All patients underwent CGA, including assessing their functionality, depressive, cognitive, and nutritional status. In addition, sleep quality was assessed by the Pittsburg Sleep Quality Index (PSQI), and RA disease activity by a rheumatologist using the Disease Activity Score 28 (DAS28-CRP), and quality of life with the RA QoL questionnaire (RAQoL). RESULTS The median age was 70 years (min-max: 65-86), and 62.5% were female. Co-morbidities and comprehensive geriatric assessment parameters were similar between the two groups. Median PSQI global score was higher in patients with RA than controls [9 (min-max: 1-20) vs. 5 (min-max: 1-13), p = 0.029). When the patients were categorized with respect to being 'poor sleepers' (PSQI score > 5), 62% of patients with RA and 38% of controls were poor sleepers (p = 0.016). The patients classified as poor sleepers were more likely to have a diagnosis of RA, higher DAS28-CRP and RAQoL scores, lower grip strength, and be a woman. PSQI global scores were significantly positively correlated with DAS28-CRP scores (r = 0.514, p < 0.001), RAQoL scores (r = 0.689, p < 0.001), number of medications used (r = 0.292, p = 0.003), and YDS scores (r = 0.407, p < 0.001), and significantly negatively correlated with handgrip strength (r = - 0.351, p = 0.001). CONCLUSION The results suggest that older patients with RA might have poorer sleep quality compared to age- and gender-matched controls. Moreover, sleep quality correlated with RA disease activity and QoL in old age.
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Qiao X, Ji L, Si H, Jin Y, Bian Y, Wang W, Liu Q, Yu J, Wang C. Validation and Comparison of Three Short Depression Screening Tools Among Chinese Community-Dwelling Older Adults. Res Gerontol Nurs 2022; 15:283-291. [PMID: 36214739 DOI: 10.3928/19404921-20220929-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study validated and compared three short Geriatric Depression Scales (GDS), including the GDS-5, D'Ath GDS-4, and van Marwijk GDS-4, among 917 Chinese community-dwelling older adults. The GDS-5, D'Ath GDS-4, and van Marwijk GDS-4 presented satisfactory accuracy against the GDS-15 (area under the curve [AUC] = 0.872 to 0.952), and the GDS-5 and D'Ath GDS-4 had better accuracy than the van Marwijk GDS-4. Satisfactory accuracy (AUC = 0.842 to 0.979) for the three scales was also observed across subgroups by age, sex, education, cognitive function, and multimorbidity. The GDS-5 but not D'Ath GDS-4 and van Marwijk GDS-4 retained a 2-point optimal cutoff for depressive symptoms across subgroups. The GDS-5 (average inter-item correlation coefficient [AIIC] = 0.233) and the D'Ath GDS-4 (AIIC = 0.171) but not van Marwijk GDS-4 (AIIC = 0.128) had acceptable internal consistency. Three scales had stable test-retest reliability within a 1- to 2-week interval (intraclass correlation coefficient = 0.670 to 0.885). The GDS-5 is an accurate and reliable depression screening tool with an invariable optimal cutoff among Chinese community-dwelling older adults. The variable optimal cutoffs for the D'Ath GDS-4 and van Marwijk GDS-4 across subgroups may limit their applicability in this population. [Research in Gerontological Nursing, xx(x), xx-xx.].
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Soysal P, Smith L. The development of a short depression screening tool in older adults. Psychogeriatrics 2022; 22:591. [PMID: 35524653 DOI: 10.1111/psyg.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/21/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
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Zhang C, Zhang H, Zhao M, Chen C, Li Z, Liu D, Zhao Y, Yao Y. Psychometric properties and modification of the 15-item geriatric depression scale among Chinese oldest-old and centenarians: a mixed-methods study. BMC Geriatr 2022; 22:144. [DOI: 10.1186/s12877-022-02833-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 02/04/2022] [Indexed: 12/29/2022] Open
Abstract
Abstract
Background
The 15-item Geriatric Depression Scale (GDS-15) shows good performance in detecting depression among older persons, but its applicability has not been well studied in non-Western oldest-old adults and centenarians. This study aimed to evaluate the psychometric property of the GDS-15 and a simplified version among a large representative longevous population in China.
Methods
A total of 1624 individuals (786 oldest-old persons aged from 80 to 99 years; 838 centenarians aged 100+ years) participated in this study. Home interviews with structured questionnaires were conducted to collect sociodemographic data. Depressive symptoms were measured using the Chinese GDS-15 version. We implemented mixed methods for the psychometric evaluation of the GDS-15. Cronbach’s α coefficient and item-total correlation coefficients were used to evaluate the internal consistency. A standard expert consultation was conducted to test the content validity of each item. Multiple factor analyses were used to explore the optimal factor structure and measurement invariance.
Results
The α coefficient of the GDS-15 was 0.745, while two items impaired the overall consistency reliability. Nineteen experts rated the applicability for each item and provided removal suggestion. Five items with less validity were removed, and a simplified 10-item GDS model with three-factor structure was proposed as an optimal solution. The GDS-10 model showed factorial equivalence across age, sex, residence, and education in multi-group confirmatory factor analyses.
Conclusions
The original GDS-15 has acceptable internal reliability, known-group validity, and concurrent validity among Chinese community-dwelling oldest-old and centenarians; however we provided preliminary evidence indicating that individual items related to somatic function or social activities may not be applicable for this population. The modified GDS-10 can be proposed as a potentially more practical and comprehensible instrument for depression screening.
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İleri İ, Borazan FY, Cavusoglu C, Göker B. The relationship between the severity of insomnia and falls in the elderly. Psychogeriatrics 2022; 22:22-28. [PMID: 34608721 DOI: 10.1111/psyg.12767] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/14/2021] [Accepted: 09/18/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Insomnia is associated with depression, cognitive impairment, hypertension, myocardial infarction, stroke, metabolic syndrome and prostate cancer in the elderly. The aim of this study is to investigate the relationship between severity of insomnia and falls. METHODS This cross-sectional study was conducted in a single geriatric outpatient clinic at a university teaching hospital. Patients with active infection, who could not complete insomnia severity index (ISI) test because of cognitive impairment and who could not perform handgrip strength and timed up and go (TUG) tests were excluded from the study. RESULTS A total of 215 patients were included in this study. Logistic regression analysis showed that there is significant relationship between poorer TUG performance, mild insomnia, moderate insomnia, severe insomnia and falls in the elderly (odds ratio (OR) = 1.04, CI: 1.00-1.09, P = 0.041, OR = 2.43, CI: 1.22-4.85, P = 0.011, OR = 3.84, CI:1.35-10.94, P = 0.012, OR = 5.81, CI:1.00-33.72, P = 0.050). CONCLUSIONS In this study we showed that there is a relationship between the severity of insomnia and falls.
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Affiliation(s)
- İbrahim İleri
- Division of Geriatric Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Funda Yıldırım Borazan
- Division of Geriatric Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Cagatay Cavusoglu
- Division of Geriatric Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
| | - Berna Göker
- Division of Geriatric Medicine, Department of Internal Medicine, Gazi University School of Medicine, Ankara, Turkey
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Brañez-Condorena A, Soriano-Moreno DR, Navarro-Flores A, Solis-Chimoy B, Diaz-Barrera ME, Taype-Rondan A. Accuracy of the Geriatric Depression Scale (GDS)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis. PLoS One 2021; 16:e0253899. [PMID: 34197527 PMCID: PMC8248624 DOI: 10.1371/journal.pone.0253899] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/16/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The Geriatric Depression Scale (GDS) is a widely used instrument to assess depression in older adults. The short GDS versions that have four (GDS-4) and five items (GDS-5) represent alternatives for depression screening in limited-resource settings. However, their accuracy remains uncertain. OBJECTIVE To assess the accuracy of the GDS-4 and GDS-5 versions for depression screening in older adults. METHODS Until May 2020, we systematically searched PubMed, PsycINFO, Scopus, and Google Scholar; for studies that have assessed the sensitivity and specificity of GDS-4 and GDS-5 for depression screening in older adults. We conducted meta-analyses of the sensitivity and specificity of those studies that used the Diagnostic and Statistical Manual of Mental Disorders (DSM) or the International Classification of Diseases-10 (ICD-10) as reference standard. Study quality was assessed with the QUADAS-2 tool. We performed bivariate random-effects meta-analyses to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI) at each reported common cut-off. For the overall meta-analyses, we evaluated each GDS-4 version or GDS-5 version separately by each cut-off, and for investigations of heterogeneity, we assessed altogether across similar GDS versions by each cut-off. Also, we assessed the certainty of evidence using the GRADE methodology. RESULTS Twenty-three studies were included and meta-analyzed, assessing eleven different GDS versions. The number of participants included was 5048. When including all versions together, at a cut-off 2, GDS-4 had a pooled sensitivity of 0.77 (95% CI: 0.70-0.82) and a pooled specificity of 0.75 (0.68-0.81); while GDS-5 had a pooled sensitivity of 0.85 (0.80-0.90) and a pooled specificity of 0.75 (0.69-0.81). We found results for more than one GDS-4 version at cut-off points 1, 2, and 3; and for more than one GDS-5 version at cut-off points 1, 2, 3, and 4. Mostly, significant subgroup differences at different test thresholds across versions were found. The accuracy of the different GDS-4 and GDS-5 versions showed a high heterogeneity. There was high risk of bias in the index test domain. Also, the certainty of the evidence was low or very low for most of the GDS versions. CONCLUSIONS We found several GDS-4 and GDS-5 versions that showed great heterogeneity in estimates of sensitivity and specificity, mostly with a low or very low certainty of the evidence. Altogether, our results indicate the need for more well-designed studies that compare different GDS versions.
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Affiliation(s)
- Ana Brañez-Condorena
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Peru
| | - David R. Soriano-Moreno
- Unidad de Investigación Clínica y Epidemiológica, Escuela de Medicina, Universidad Peruana Unión, Lima, Peru
| | | | - Blanca Solis-Chimoy
- Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Peru
- Asociación para el Desarrollo de la Investigación Estudiantil en Ciencias de la Salud (ADIECS), Lima, Peru
| | - Mario E. Diaz-Barrera
- Unidad de Investigación en Bibliometría, Universidad San Ignacio de Loyola, Lima, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Trujillo, SOCEMUNT, Trujillo, Peru
| | - Alvaro Taype-Rondan
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Lima, Peru
- * E-mail:
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Park SH, Kwak MJ. Performance of the Geriatric Depression Scale-15 with Older Adults Aged over 65 Years: An Updated Review 2000-2019. Clin Gerontol 2021; 44:83-96. [PMID: 33164674 DOI: 10.1080/07317115.2020.1839992] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This up-to-date systematic review and meta-analysis aimed to examine the predictive validity of the Geriatric Depression Scale-15 (GDS-15) for screening depression in older adults aged over 65 years. METHODS Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO database using the following keywords: depression, depressive disorder, major, geriatric depression scale, and geriatric depression scale short. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias in diagnostic studies. RESULTS Thirty-one studies that included 8,897 older adults were analyzed. The pooled sensitivity of the GDS-15 was 0.80 (95% CI:0.78 to 0.82), its pooled specificity was 0.79 (95% CI:0.78 to 0.80), the area under the curve (AUC) was 0.89 (SE = 0.01) and the Q* value was 0.82 (SE = 0.01). The subgroup analysis revealed that the pooled sensitivity and specificity of the GDS-15 were higher in older adults with normal cognitive function than in those with cognitive impairment. CONCLUSIONS These finding suggest that the GDS-15 may be more accurate for screening depression in older adults with normal cognitive function. CLINICAL IMPLICATIONS The utility the GDS-15 may be restricted because its diagnostic accuracy is slightly lower among older adults with cognitive impairment.
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Affiliation(s)
- Seong-Hi Park
- School of Nursing, Soonchunhyang University , Asan, South Korea
| | - Mi-Jeong Kwak
- Quality Improvement Team, Korea University Anam Hospital , Seoul, South Korea
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Zhang C, Zhang H, Zhao M, Liu D, Zhao Y, Yao Y. Assessment of Geriatric Depression Scale's Applicability in Longevous Persons based on Classical Test and Item Response Theory. J Affect Disord 2020; 274:610-616. [PMID: 32663994 DOI: 10.1016/j.jad.2020.05.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/02/2020] [Accepted: 05/15/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND The 15-item short form Geriatric Depression Scale (GDS-15) has been widely used for depression screening in multiple settings. However, few studies have specifically investigated the applicability of GDS-15 in longevous population. The aim of this study is to evaluate the psychometric property and item characteristic of the scale in Chinese community-dwelling longevous persons. MATERIALS AND METHODS A total of 838 longevous people participated in this study. The reliability and validity of GDS-15 were analyzed with classical test theory, and the characteristics of each item were analyzed with item response theory using a three-parameters logistic model. RESULTS The Cronbach's α coefficient of the scale was 0.776. Spearman correlation coefficients between the GDS-15 score and each item were between 0.274 and 0.667 (P<0.01); the summed GDS-15 score was negatively associated with physical function, self-report health status and subjective well-being. Factors extracted using exploratory factor analysis accounted for 52.63% of the variance and the item loadings were between 0.513 and 0.828. The discrimination of each item ranged from 1.045 to 3.777; the difficulty ranged from -0.972 to 2.006, and the guessing parameter ranged from 0.000 to 0.499. The total information of GDS-15 was 13.645 when the subject's latent trait located at 1.131. LIMITATION The sample used is representative of the longevous in rural communities, thus extrapolation to other populations requires further validation. CONCLUSION The GDS-15 has good applicability in depression detecting among Chinese longevous persons, especially for the individuals with moderate symptoms. Suggestions were provided on further improving its measurement precision.
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Affiliation(s)
- Chi Zhang
- Department of Education, Beijing Hospital, National Center of Gerontology, Beijing, China; Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hao Zhang
- Weill Cornell Medical College, Ithaca, NY, USA
| | - Minghao Zhao
- Peking University Health Science Center, Beijing, China
| | - Deping Liu
- Department of Education, Beijing Hospital, National Center of Gerontology, Beijing, China; Institute of Geriatrics Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese PLA General Hospital, Sanya, Hainan, China.
| | - Yao Yao
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China; Center for the Study of Aging and Human Development and Geriatrics Division, Medical School of Duke University, Durham, North Carolina..
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Assessment of factors that increase risk of falling in older women by four different clinical methods. Aging Clin Exp Res 2020; 32:483-490. [PMID: 31115877 DOI: 10.1007/s40520-019-01220-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 05/08/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Women aged 65 years and over are at increased risk of falling. Falls in this age group increase the risk of morbidity and mortality. AIMS The aim of the present study was to find the most common factors that increase the risk of falling in older women, by using four different assessment methods. METHODS 682 women, who attended a geriatric outpatient clinic and underwent comprehensive geriatric assessment, were included in the study. History of falling last year, the Timed Up and Go (TUG) test, Performance-Oriented Mobility Assessment (POMA), and 4-m walking speed test were carried out on all patients. RESULTS The mean age (SD) of patients were 74.4 (8.5) years. 31.5% of women had a history of falling in the last year. 11%, 36.5%, and 33.3% of patients had a falling risk according to POMA, TUG and 4-m walking speed test, respectively. We identified the following risk factors that increase the risk of falling, according to these four methods: urinary incontinence, dizziness and imbalance, using a walking stick, frailty, dynapenia, higher Charlson Comorbidity Index and Geriatric Depression Scale score, and lower basic and instrumental activities of daily living scores (p < 0.05). We found a significant correlation between all the assessment methods (p < 0.001). CONCLUSION There is a strong relationship between fall risk and dizziness, using a walking stick, dynapenia, high number of comorbidities, low functionality, and some geriatric syndromes such as depression, frailty, and urinary incontinence in older women. Therefore, older women should routinely be screened for these risk factors.
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Soysal P, Smith L, Dokuzlar O, Isik AT. Relationship Between Nutritional Status and Insomnia Severity in Older Adults. J Am Med Dir Assoc 2019; 20:1593-1598. [DOI: 10.1016/j.jamda.2019.03.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 03/23/2019] [Accepted: 03/26/2019] [Indexed: 12/23/2022]
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Eriksen S, Bjørkløf GH, Helvik AS, Larsen M, Engedal K. The validity of the hospital anxiety and depression scale and the geriatric depression scale-5 in home-dwelling old adults in Norway ✰. J Affect Disord 2019; 256:380-385. [PMID: 31212233 DOI: 10.1016/j.jad.2019.05.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/20/2019] [Accepted: 05/27/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the validity of the Norwegian versions of the Geriatric Depression Scale-5 (GDS-5) and the Hospital Anxiety and Depression Scale-D (HADS-D). The aim of this study was therefor to validate the two assessment tools in a population of home-dwelling persons of 60 years of age and above. METHODS A sample of 194 home-dwelling old adults with and without depressive symptoms were recruited. The participants were examined for depressive symptoms (GDS-5, HADS-D) and cognitive impairment. Sociodemographic information was collected. The participants underwent a blinded diagnostic evaluation for a depressive episode according to the diagnostic criteria of ICD-10. RESULTS In all, 56 (28.9%) participants fulfilled criteria for a depressive episode according to ICD-10. The Receiver Operating Characteristics analyses of HAD-D and GDS-5 using the diagnostic criteria of ICD-10 for depression as gold standard was performed. For GDS-5 the Areal under the Curve was 0.81 and for HAD-D 0.75. The cut-off points of the measures that produced the highest accuracies were ≥2 for GDS-5 with a sensitivity of 73.2% and a specificity of 73.2% and ≥4 for HADS-D with a sensitivity of 70.3% and a specificity of 69.6%. LIMITATIONS A larger sample would have given the opportunity for analyzing home dwelling old adults with and without home health care separately. The participants were talked through the self-filling questionnaires. The procedure could have influenced the participants' answers. CONCLUSION GDS-5 and HADS-D are useful screening tools for old adults, but only fairly good to identify depression according to criteria of ICD-10.
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Affiliation(s)
- S Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway.
| | - G H Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway
| | - A-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Postboks 8905, N-7491 Trondheim, Norway
| | - M Larsen
- Department of Geriatric Psychiatry, Diakonhjemmet, Oslo, Postboks 23, Vinderen, N-0319 Oslo, Norway
| | - K Engedal
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway
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Esenkaya ME, Dokuzlar O, Soysal P, Smith L, Jackson SE, Isik AT. Validity of the Kihon Checklist for evaluating frailty status in Turkish older adults. Geriatr Gerontol Int 2019; 19:616-621. [PMID: 31064033 DOI: 10.1111/ggi.13678] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 03/28/2019] [Accepted: 04/03/2019] [Indexed: 01/02/2023]
Abstract
AIM The Kihon Checklist (KCL) was developed to identify vulnerable older adults residing in Japan who are at a high risk of becoming dependent. The present study aimed to determine the validity of the KCL for detecting frailty in Turkish older adults. METHODS A total of 300 outpatients were enrolled in the study. All patients underwent comprehensive geriatric assessment and completed a Turkish translation of the KCL. Frailty status was defined by five dimensions, including weight loss, exhaustion, low levels of activity, weakness and slowness: 0 for robust, 1-2 for prefrail and 3-5 for frail. RESULTS The mean age of the patients was 73.85 ± 7.12 years. According to Fried definitions, 25.7% were considered frail, 48.0% prefrail and 26.3% robust. There was a significant difference between the groups in terms of age, sex, education, Charlson's Comorbidity Index, the number of medications used, sarcopenia, dynapenia and all the comprehensive geriatric assessment parameters (P < 0.05). Cronbach's α value of the KCL was 0.876. The area under the receiver operating characteristics curve was 0.855 for frail, and 0.697 for prefrail. We found that the KCL can show frail and prefrail older adults when the cut-off values are ≥9 and ≥ 4, respectively, with a sensitivity of 80.52% and 65.28%, and specificity of 81.17% and 56.96%. CONCLUSIONS The KCL can be used as a quick, simple and sensitive screening method for detecting frailty among Turkish older adults. We recommend its use by healthcare professionals in Turkey in order to identify frail older adults and direct them to relevant support. Geriatr Gerontol Int 2019; 19: 616-621.
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Affiliation(s)
- Mehmet Erdinc Esenkaya
- Faculty of Medicine, Department of Internal Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ozge Dokuzlar
- Faculty of Medicine, Department of Geriatric Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pinar Soysal
- Faculty of Medicine, Department of Geriatric Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Lee Smith
- The Cambridge Center for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Sarah E Jackson
- Department of Behavioral Science and Health, University College London, London, UK
| | - Ahmet Turan Isik
- Faculty of Medicine, Department of Geriatric Medicine, Dokuz Eylul University, Izmir, Turkey.,Faculty of Medicine, Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Dokuz Eylul University, Izmir, Turkey
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Soysal P, Smith L, Capar E, Kalan U, Arik F, Isik AT. Vitamin B12 and folate deficiencies are not associated with nutritional or weight status in older adults. Exp Gerontol 2018; 116:1-6. [PMID: 30550763 DOI: 10.1016/j.exger.2018.12.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/25/2018] [Accepted: 12/10/2018] [Indexed: 12/22/2022]
Abstract
It is not known whether undernutrition causes vitamin B12 and folate deficiencies. The present study aimed to determine whether nutritional status, measured using the Mini Nutritional Assessment (MNA) scale, and body mass index (BMI) are indicators of lower level serum vitamin B12 and folate in older adults. 1007 outpatients aged 65 years or over were included the study. MNA scores >23.5, 17-23.5, <17, were categorized as normal nutritional status, risk of malnutrition, and malnutrition, respectively. Weight status was assessed using BMI and categorized as under or normal weight (<25 kg/m2), overweight (25-30 kg/m2), class I obese (30.0-35 kg/m2), class II obese (35-40 kg/m2), and class III obese (≥40 kg/m2). Vitamin B12 and folate deficiencies were defined as <200 pg/ml and <3 ng/ml, respectively. Among 1007 patients with an average age of 74.3 ± 8.2 years, 6.9% were categorized as having malnutrition and 31.2% were categorized as at risk of malnutrition. While 45.7% of patients were categorized as having vitamin B12 deficiency and 0.9% folate deficiency. There were no differences between patients with malnutrition, at risk of malnutrition, and good nutrition in serum vitamin B12 or folate levels, or the presence of vitamin B12 or folate deficiency after adjustment for age, gender, and education (p > 0.05). The results were the same across BMI classifications (p > 0.05). Vitamin B12 and folate levels are not associated with nutritional or weight status and these should be evaluated independently of BMI and MNA values.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, United Kingdom
| | - Emre Capar
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ugur Kalan
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ferhat Arik
- Kayseri Education and Research Hospital, Geriatric Center, Department of Internal Medicine, Kayseri, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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