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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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Tai CJ, Yang YH, Huang CY, Pan SC, Hsiao YH, Tseng TG, Lee MC. Development of the Brief Geriatric Assessment for the General Practitioner. J Nutr Health Aging 2021; 25:134-140. [PMID: 33367474 DOI: 10.1007/s12603-020-1456-7] [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] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The study aimed to develop a brief geriatric assessment (BGA) tool for the general practitioner to evaluate geriatric syndromes in community-dwelling older adults. DESIGN A cross-sectional study. SETTING 58 communities from four aging cities in Taiwan. PARTICIPANTS 1,258 community-dwelling older adults aged 65 years and above. MEASUREMENTS The BGA targeted physical function impairment, cognitive impairment, and mood impairment. The cutoff values of physical function tests (handgrip strength and 6-meter walk test [6MWT]) were estimated by receiver operating characteristic analysis. Second, the diagnostic validity of the BGA was calculated in terms of sensitivity, specificity, and predictive values, which were compared to corresponding comprehensive geriatric assessment (CGA) items. Third, the associated risk factors of geriatric syndromes were selected using stepwise logistic regression. Finally, we combined items selected from literature and CGA and then proposed a practical BGA framework. RESULTS The proposed BGA comprised dominant handgrip strength, 6MWT, self-report personal birthday, address, and telephone number, question 'Do you have depressive mood for the past two weeks?', Rinne tuning-fork tests, Snellen scale, and body mass index. It evaluated multidimensional aspects of geriatrics syndromes including physical, cognitive, mood, and sensory impairment, sarcopenia, and nutrition status. Sensitivities in the Taiwan BGA items ranged from 48% for dominant handgrip strength to 97.6% for 6MWT corresponding to physical impairment; 58.3% for cognitive impairment corresponding to Short Portable Mental Status Questionnaire; 62.7% for mood impairment corresponding to Geriatric Depression Scale. The Taiwan BGA for the general practitioner takes less than 10 minutes and is suitable in the community setting. CONCLUSION Early management of geriatric syndromes in the community is important. The current study demonstrated a practical BGA tool for the general practitioner to comprehensively assess geriatric syndromes in community-dwelling older adults.
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Affiliation(s)
- C-J Tai
- Dr. Tzyy-Guey Tseng, No.100, Shin-Chuan 1st Road, Sanmin Dist., Kaohsiung City 80708, Taiwan (R.O.C.), Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan, ; Tel: +886-7-3121101 ext. 7021; Prof. Meng-Chih Lee, No. 199, Sec. 1, Sanmin Rd., West Dist., Taichung City 403, Taiwan (R.O.C.), Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taiwan, ; Tel: +886-4-22294411
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Huang C, Kogure M, Tomata Y, Sugawara Y, Hozawa A, Momma H, Tsuji I, Nagatomi R. Association of serum adiponectin levels and body mass index with worsening depressive symptoms in elderly individuals: a 10-year longitudinal study. Aging Ment Health 2020; 24:725-731. [PMID: 30884953 DOI: 10.1080/13607863.2019.1584877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Data regarding the association between adiponectin levels and body mass index (BMI) and long-term changes in depressive symptoms are limited and inconsistent. Thus, we investigated whether circulating adiponectin levels and BMI were independently and combinedly correlated to longitudinal changes in depressive symptoms.Methods: This prospective cohort study evaluated 269 elderly Japanese individuals aged ≥70 years who participated in the Tsurugaya Project conducted between 2002 and 2012. A short form of the Geriatric Depression Scale (GDS) was used to assess depressive status. Serum adiponectin levels were measured using an enzyme-linked immunosorbent assay or a latex particle-enhanced turbidimetric immunoassay. BMI was calculated as body weight (kg)/height (m2).Results: Multiple linear regression analysis revealed that baseline serum adiponectin levels were positively associated with changes in GDS scores (β = 0.14, P = 0.035). However, no association was observed after adjusting for BMI (β = 0.09, P = 0.185). Low BMI was associated with increased GDS scores at the 10-year follow-up (β = -0.14, P = 0.033). Participants with a combination of high adiponectin levels and low BMI had a 3.3-fold higher risk of worsening depressive symptoms than those with low adiponectin levels and high BMI (odds ratio: 3.35, 95% confidence interval: 1.60-7.00; P = 0.001).Conclusions: This longitudinal study indicated that high serum adiponectin levels and low BMI were both associated with worsening depressive symptoms among older Japanese individuals. Furthermore, the combination of high adiponectin levels and low BMI was associated with worsening depressive symptoms.
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Affiliation(s)
- Cong Huang
- Department of Sports and Exercise Science, College of Education, Zhejiang University, 148 Tianmushan Road, Hangzhou, China.,Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Mana Kogure
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku Universit, Sendai, Japan
| | - Yasutake Tomata
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yumi Sugawara
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Atsushi Hozawa
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku Universit, Sendai, Japan
| | - Haruki Momma
- Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
| | - Ichiro Tsuji
- Department of Health Informatics and Public Health, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoichi Nagatomi
- Department of Medicine and Science in Sports and Exercise, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering, Sendai, Japan
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Shastri A, Aimola L, Tooke B, Quirk A, Corrado O, Hood C, Crawford MJ. Recognition and treatment of depression in older adults admitted to acute hospitals in England. Clin Med (Lond) 2019; 19:114-118. [PMID: 30872291 PMCID: PMC6454375 DOI: 10.7861/clinmedicine.19-2-114] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Levels of awareness and treatment of depression in older adults admitted to acute hospitals are unclear. This study aims to examine the proportion of older adults diagnosed with depression in acute hospitals, treatment, referral, and communication between secondary and primary healthcare services following discharge. Retrospective examination of records of 766 older adults admitted to 27 acute hospitals in England was carried out. Ninety-eight (12.7%, 95% confidence interval (CI) = 10.6-15.3) records included a diagnosis of depression of which eight (1.0%, 95% CI = 0.5-2.0) had a new diagnosis made during their hospital admission. All newly diagnosed and 76 (84.4%, 95% CI = 75.5-90.5) of those with an existing diagnosis of depression were prescribed antidepressant medication. Six (75.0%, 95% CI = 40.9-92.8) of those with a new diagnosis, and 21 (23.3%, 95% CI = 15.8-33.0) with an existing diagnosis of depression were referred to liaison psychiatry. References to mental health were made in 50 (51.0%, 95% CI = 41.2-60.6) discharge letters sent to primary care. Very few older adults admitted to acute hospitals in this study were diagnosed with depression during their inpatient stay. Opportunities for improving the mental and physical health of such patients appear to be being missed.
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Affiliation(s)
| | | | | | - Alan Quirk
- Royal College of Psychiatrists, London, UK
| | | | - Chloe Hood
- Royal College of Psychiatrists, London, UK
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Tsoi KKF, Chan JYC, Hirai HW, Wong SYS. Comparison of diagnostic performance of Two-Question Screen and 15 depression screening instruments for older adults: systematic review and meta-analysis. Br J Psychiatry 2017; 210:255-260. [PMID: 28209592 DOI: 10.1192/bjp.bp.116.186932] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/02/2016] [Accepted: 11/13/2016] [Indexed: 12/20/2022]
Abstract
BackgroundScreening for depression in older adults is recommended.AimsTo evaluate the diagnostic accuracy of the Two-Question Screen for older adults and compare it with other screening instruments for depression.MethodWe undertook a literature search for studies assessing the diagnostic performance of depression screening instruments in older adults. Combined diagnostic accuracy including sensitivity and specificity were the primary outcomes. Potential risks of bias and the quality of studies were also assessed.ResultsA total of 46 506 participants from 132 studies were identified evaluating 16 screening instruments. The majority of studies (63/132) used various versions of the Geriatric Depression Scale (GDS) and 6 used the Two-Question Screen. The combined sensitivity and specificity for the Two-Question Screen were 91.8% (95% CI 85.2-95.6) and 67.7% (95% CI 58.1-76.0), respectively; the diagnostic performance area under the curve (AUC) was 90%. The Two-Question Screen showed comparable performance with other instruments, including clinician-rated scales. The One-Question Screen showed the lowest diagnostic performance with an AUC of 78%. In subgroup analysis, the Two-Question Screen also had good diagnostic performance in screening for major depressive disorder.ConclusionsThe Two-Question Screen is a simple and short instrument for depression screening. Its diagnostic performance is comparable with other instruments and, therefore, it would be favourable to use it for older adult screening programmes.
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Affiliation(s)
- Kelvin K F Tsoi
- Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Joyce Y C Chan
- Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Hoyee W Hirai
- Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Samuel Y S Wong
- Kelvin K. F. Tsoi, PhD, Jockey Club School of Public Health and Primary Care and Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Joyce Y. C. Chan, MPH, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong; Hoyee W. Hirai, MSc, Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Shatin, Hong Kong; Samuel Y. S. Wong, MPH, MD, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
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Esiwe C, Baillon S, Rajkonwar A, Lindesay J, Lo N, Dennis M. Screening for depression in older people on acute medical wards: the validity of the Edinburgh Depression Scale. Age Ageing 2016; 45:554-8. [PMID: 27126326 DOI: 10.1093/ageing/afw075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 03/14/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND depression is common in people with poor physical health, particularly within the acute medical in-patient setting. Co-morbid depression contributes to poor outcomes, and screening for depression in acute medical in-patients has been advocated. The Edinburgh Depression Scale (EDS) has been validated in a variety of general hospital patient groups, but not previously in older acute medical in-patients. METHODS one hundred and eighteen patients aged 65 and older on acute medical wards were assessed using a standardised diagnostic interview (Present State Examination-Schedules for Clinical Assessment in Neuropsychiatry) to identify depression according to ICD-10 criteria. They subsequently completed the EDS. The performance characteristics at a range of thresholds were compared, and receiver operating characteristic curve analysis was performed. RESULTS the optimal EDS cut-off for identifying ICD-10 depressive episode was 7/8, with a sensitivity of 88%, specificity of 77%, positive predictive value of 52% and negative predictive value of 96%. The area under the receiver operating characteristic curve was 0.91. CONCLUSION the EDS was shown to be a useful instrument for detecting clinical depression in older people on acute medical wards in this study. Its performance was equivalent to other validated screening instruments in this population. Our findings add further weight to using the EDS as a screening instrument for depression in multiple general hospital settings.
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Affiliation(s)
- Collins Esiwe
- Lincolnshire Partnership NHS Foundation Trust, Sleaford, Lincolnshire, UK
| | - Sarah Baillon
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | | | - James Lindesay
- Department of Health Sciences, University of Leicester, Leicester LE1 7RH, UK
| | - Nelson Lo
- Department of Medicine for the Elderly, Leicester General Hospital, Leicester LE5 4PW, UK
| | - Michael Dennis
- College of Medicine, Swansea University, Swansea, Wales, UK
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