Geriatric Depression Scale 15-item Version Research Articles

Components of an indirect cognitive reserve: a longitudinal assessment of community-dwelling older adults

ABSTRACT Cognitive reserve enables individuals to preserve their cognition, despite a possible underlying brain pathology. The objective was to verify which components contribute to an indirect measurement of cognitive reserve in older adults, assessed longitudinally within a four-year interval. The sample was comprised of 64 older adults from the community. The following instruments were used: sociodemographic form; Mini-Mental State Examination; subtests from the Wechsler Adult Intelligence Scale – Third Edition; Trail Making Test; Verbal Fluency Test (animal category); Rey Auditory-Verbal Learning Test; Beck Anxiety Inventory; and the Geriatric Depression Scale 15-item version. Multiple linear regression analyses were performed for the data analysis. The sample was predominantly composed of women (81.3%) and the mean age of the sample was 73.19 years (SD = 6.12). With respect to the variables related to cognitive reserve, it was found that anxiety was the predictor variable of more cognitive components: It was found that poorer cognitive performance is associated with anxiety, and this variable is negatively related to cognitive reserve, as well as to the age variable. Engaging in cognitively stimulating activities, education level and living with someone were deemed to be factors that help build cognitive reserve in older adults. Keywords: cognitive reserve; older adults; longitudinal.

Cognitive function of Brazilian elderly persons: longitudinal study with non-clinical community sample

Several biopsychosocial changes in individuals' life might happen, resulting in a decline of long-term cognitive abilities. In this way, the aim of this study was to compare cognition in non-clinical older adults in Brazil during a four-year period, as well as to examine which variables may explain cognitive function variations identified during this time. For this purpose, a longitudinal study was developed including 108 older Brazilians in phase I and 64 in phase II, from 2013 to 2017. Socio-demographic variables were assessed and the following instruments were administered: the Mini-Mental State Examination (MMSE), the Wechsler Adult Intelligence Scale (WAIS) - 3rd Edition - Digital Symbol-Coding subtests, the Verbal Fluency Test (animal category), the Rey Auditory-Verbal Learning Test, the Beck Anxiety Inventory (BAI), and the Geriatric Depression Scale 15-item version (GDS-15). In order to compare cognitive variables, the Wilcoxon signed-rank test for repeated measures was used. Temporal comparisons of nominal variables were carried out using McNemar’s chi-square tests for matched pairs. Finally, multiple linear regression and correlation analyses were applied, using the participants’ cognitive performance variation scores (Δ) as dependent variables. Global cognitive function delayed verbal episodic memory, and processing speed experienced a significant decline in four years. Symptoms of anxiety were the main predictor of cognitive performance variations in this sample.

Effects of Music Therapy in Frail Elderlies: Controlled Crossover Study

Background: Music therapy (MT) may exert beneficial preventive effects in frail elderly individuals in psychophysiological health. Objectives: One hundred and fifteen frail elderly individuals (65–89 years old) participated. Methods: Subjects were randomly divided into 2 groups for a controlled crossover trial. The MT-first group participated in group sessions of 45–50 min conducted by a certified music therapist for 12 weeks, followed by a 12-week waiting period. The waiting-first group participated in the reverse order. Cognitive function was assessed by the Verbal Fluency Test (VFT) and Yamaguchi Kanji Symbol Substitution Test (YKSST). Physical function was assessed by the Timed Up and Go test (TUG). Psychophysical health was assessed by the Geriatric Depression Scale 15-item version (GDS-15), General Health Questionnaire 12-item version (GHQ-12), Instrumental Activity of Daily Living (IADL) scale, and Life Space Assessment (LSA) scale. We also evaluated the outcome of MT using the Clinical Global Impressions of Improvement (CGI-I) scale. Results: After 12 weeks of MT, significant improvements were observed in TUG, GDS-15, and GHQ-12 scores. However, no improvements were noted in other scores. CGI-I scores revealed the significant benefits of MT. Conclusions: MT may improve physical function, depressive mood, and quality of life in frail elderly individuals.

Validation of the Patient Health Questionnaire for Depression Screening Among the Elderly Patients in Taiwan

Summary Background This study aimed to assess the reliability, validity, and factor structure of the Patient Health Questionnaire-9 (PHQ-9) and its two subscales (PHQ-2, PHQ-1) for screening major depression disorder (MDD) in primary care elderly patients in Taiwan. Method A total of 634 participants aged ≥60 years were enrolled from the primary care settings. They completed PHQ-9, and Short Form of Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q-SF). After that, they were interviewed by using Schedule for Clinical Assessments in Neuropsychiatry (SCAN) and 17-item of Hamilton Rating Scale (HAMD-17). Result The PHQ-9 demonstrated acceptable internal consistency (α = 0.77), test-retest reliability (intraclass correlation coefficient = 0.79), and concurrent validity with HAMD-17 ( r = 0.66; p r range −0.47 to −0.53, all p s Conclusion The Chinese versions of the PHQ-9 and its two subscales (PHQ-2 and PHQ-1) are valid and reliable to screen MDD in primary care elderly patients in Taiwan and could be proper alternatives to Geriatric Depression Scale 15-item version.

Development and preliminary validation of an Observation List for detecting mental disorders and social Problems in the elderly in primary and home care (OLP).

ObjectiveEven though the prevalence of mental disorders and social problems is high among elderly patients, it is difficult to detect these in a primary (home) care setting. Goal was the development and preliminary validation of a short observation list to detect six problem areas: anxiety, depression, cognition, suspicion, loneliness, and somatisation.MethodsA draft list of indicators identified from a short review of the literature and the opinions of 22 experts was evaluated by general practitioners (GPs) and home care organisations for feasibility. It was then used by GPs and home care personnel to observe patients, who also completed validated tests for psychological disorders (General Health Questionnaire 12 item version (GHQ‐12)), depression (Geriatric Depression Scale 15‐item version (GDS‐15)), anxiety and suspicion (Symptom Checklist‐90 (SCL‐90)), loneliness (University of California, Los Angeles (UCLA)), somatisation (Illness Attitude Scale (IAS)), and cognition (Mini‐Mental State Examination (MMSE)).ResultsGPs and home care personnel observed 180 patients (mean age 78.4 years; 66% female) and evaluated the draft list during a regular visit. Cronbach's α was 0.87 for the draft list and ≥0.80 for the draft problem areas (loneliness and suspicion excepted). Principal component analysis identified six components (cognition, depression + loneliness, somatisation, anxiety + suspicion, depression (other signs), and an ambiguous component). Convergent validity was shown for the indicators list as a whole (using the GHQ‐12), and the subscales of depression, anxiety, loneliness, cognition, and somatisation. Using pre‐set agreed criteria, the list was reduced to 14 final indicators divided over five problem areas.ConclusionThe Observation List for mental disorders and social Problems (OLP) proved to be preliminarily valid, reliable, and feasible for use in primary and home care settings. Copyright © John Wliey & Sons, Ltd.

Higher Serum Dehydroepiandrosterone Sulfate Levels Are Protectively Associated with Depressive Symptoms in Men, But Not in Women: A Community-Based Cohort Study of Older Japanese

Dehydroepiandrosterone sulfate (DHEAS) appears to have a protective effect against depression, but evidence from prospective cohort studies is sparse. Therefore, we examined the association between serum DHEAS levels and depressive symptoms in older community-dwelling Japanese. A community-based cohort study. Kurabuchi Town, Gunma Prefecture, Japan. A total of 554 residents (248 men and 306 women) age 65 years or older without depressive symptoms at baseline. We performed a baseline examination of the subjects between 2005 and 2006 to determine serum DHEAS levels. The subjects were categorized into three groups based on age strata- and sex-specific tertiles of DHEAS. Depressive symptoms were assessed with the Geriatric Depression Scale 15-item version (GDS-15) in face-to-face home visit interviews carried out once in 2007 and once in 2008. The association of DHEAS with depressive symptoms (GDS-15 ≥ 6) was analyzed with the use of logistic regression models. The incidence of depressive symptoms was 12.1% in men and 19.6% in women. In men, the multiadjusted odds ratio of depressive symptoms was 0.24 (95% confidence interval: 0.06-0.94, Wald χ2 = 4.20, degrees of freedom = 1, p = 0.04) for the highest tertile compared with the lowest. The association observed for the highest versus the lowest remained significant even after adjustment for physical performance and cognitive function. In women, DHEAS was not associated with depressive symptoms. In this study, higher serum DHEAS levels were found to be protectively and independently associated with the risk of developing depressive symptoms in men, but not in women.

Beside the Geriatric Depression Scale: the WHO‐Five Well‐being Index as a valid screening tool for depression in nursing homes

The aim of the study was to compare criterion validities of the WHO-Five Well-being Index (WHO-5) and the Geriatric Depression Scale 15-item version (GDS-15) and 4-item version (GDS-4) as screening instruments for depression in nursing home residents. Data from 92 residents aged 65-97 years without severe cognitive impairment (Mini Mental State Examination ≥15) were analysed. Criterion validities of the WHO-5, the GDS-15 and the GDS-4 were assessed against diagnoses of major and minor depression provided by the Structured Clinical Interview for DSM-IV. Subanalyses were performed for major and minor depression. Areas under the receiver operating curve (AUCs) as well as sensitivities and specificities at optimal cut-off points were computed. Prevalence of depressive disorder was 28.3%. The AUC value of the WHO-5 (0.90) was similar to that of the GDS-15 (0.82). Sensitivity of the WHO-5 (0.92) at its optimal cut-off of ≤12 was significantly higher than that of the GDS-15 (0.69) at its optimal cut-off of ≥7. The WHO-5 was equally sensitive for the subgroups of major and minor depression (0.92), whereas the GDS-15 was sensitive only for major depression (0.85), but not for minor depression (0.54). For specificity, there was no significant difference between WHO-5 (0.79) and GDS-15 (0.88), but both instruments outperformed the GDS-4 (0.53). The WHO-5 demonstrated high sensitivity for major and minor depression. Being shorter than the GDS-15 and superior to the GDS-4, the WHO-5 is a promising screening tool that could help physicians improve low recognition rates of depression in nursing home residents.

Tinnitus preceded depressive symptoms in community-dwelling older Japanese: A prospective cohort study

ObjectiveMost studies of the association between tinnitus and depression have been cross-sectional, making it difficult to draw any conclusions about the directionality of the association. This study aimed to clarify whether tinnitus precedes the development of depressive symptoms in a general older population. MethodsResidents of Kurabuchi Town, Gunma Prefecture, Japan (239 men, 296 women: ≥65years) without depressive symptoms were given health examinations in 2005–2006. Information on tinnitus was obtained via a questionnaire. Depressive symptoms were then assessed in a face-to-face home visit interviews carried out once in 2007 and once in 2008 according to the Geriatric Depression Scale 15-item version (GDS15). ResultsAmong the men, the 2.5-year incidence of depressive symptoms (GDS15≥6) was higher in those with tinnitus than in those without (20.5% vs. 9.5%). In the multi-adjusted model, tinnitus was significantly associated with an increased risk of depressive symptoms (relative risk=2.07; 95% confidence interval=1.01–4.25). Among the women, no associations were found. ConclusionIn the present study, tinnitus was independently associated with the risk of depressive symptoms developing in men, but not in women. We believe primary care providers and public health staff should recognize tinnitus as a risk factor for depressive symptoms.

Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment

Objectives: The aim of this population-based study was to investigate the usefulness of the Geriatric Depression Scale 15-item version (GDS-15) to assess depressive symptoms among very old people with differing levels of cognitive function. Methods: The 834 participants were aged 85 and over. Feasibility of GDS-15 was evaluated as the proportion of people who completed the scale. Concurrent criterion validity was evaluated by calculating correlations between GDS-15 and Philadelphia Geriatric Center Morale Scale (PGCMS). PGCMS measures psychological wellbeing which is closely related with depressive symptoms. Correlations were calculated within groups according to cognitive function assessed with Mini-Mental State Examination (MMSE); 0–4, 5–9, 10–14, 15–19, 20–24, 25–27, and 28–30, using Pearson's two-sided correlation and compared using Fisher r-to-z transformation. Internal consistency of the GDS-15 was evaluated by calculating Cronbach's α in each group. Results: In total, 651 (78%) of the 834 participants completed the GDS-15. For the two MMSE-groups with scores of <10, the proportion who completed GDS-15 were 1% and 42%, respectively, compared to 65–95% in the MMSE-groups with scores of ≥10. Cronbach's α in each MMSE-group ranged from 0.636 (MMSE 28–30) to 0.821 (MMSE 5–9). The level of correlation between GDS-15 and PGCMS did not significantly differ between MMSE-groups with scores of 5–27 compared to the MMSE-group with scores of 28–30. Conclusions: The GDS-15 seems to have an overall usefulness to assess depressive symptoms among very old people with an MMSE score of 10 or more. More studies are needed to strengthen the validity of GDS-15 among older people with MMSE scores of 10–14. For older people with MMSE scores lower than 10, there is a need to develop and validate other measurements.

The Cornell-Brown Scale for Quality of Life in Dementia

The objective of this study was to validate a Spanish version of the Cornell-Brown Scale (CBS) for quality of life (QoL) in dementia. One hundred persons with mild-to-moderate dementia (Diagnostic and Statistical Manual of the American Psychiatric Association, 4th edition) were recruited and interviewed at 5 Spanish centers to obtain sociodemographic information, health perceptions, depressive symptoms (Geriatric Depression Scale 15-item version), functional ability (Barthel Index), dementia severity (Mini-Mental State Examination), specific QoL (CBS), and generic QoL (World Health Organization Quality of Life-BREF version). Analysis was carried out using classical psychometric methods. Internal consistency reliability for the CBS was good (0.87). A priori hypotheses about the relationship between CBS and the World Health Organization Quality of Life-BREF version psychological domain and Geriatric Depression Scale 15-item version were confirmed, indicating good construct validity. Regarding contrasting groups' differences, CBS scores significantly differentiated between healthy and unhealthy and depressed and nondepressed participants but not between those with mild and moderate dementia. The exploratory factor analysis showed a 5-factor solution, which accounted for 63.9% of the total variance of CBS. This study is the first to report the factor structure of the CBS. These results indicate that CBS is a useful tool in assessing persons with dementia. Replication of these results with larger samples is advised. The Spanish version of the CBS is reliable and valid in persons with mild/moderate dementia who are living at home and with a known caregiver.

Using the WHOQOL-BREF in Persons With Dementia

Increasing evidence suggests that persons with early dementia can give reliable and valid assessments about their own quality of life (QOL), thereby improving accuracy, and reducing the need for proxy informants. The objective of this study was to examine QOL in persons diagnosed with dementia (Diagnostic and Statistical Manual of Mental Disorder-IV) using a battery of subjective assessments including the new World Health Organization Quality of Life (WHOQOL-BREF). Persons with mild-to-moderate dementia (n=104) were recruited and interviewed at 6 Spanish centers to obtain sociodemographic information, health perceptions, depressive symptoms (Geriatric Depression Scale 15-item version), functional ability (Barthel Index), generic QOL (WHOQOL-BREF), and specific QOL (DEMQOL-28). Analysis was performed using classical psychometric methods. Internal consistency reliability for the WHOQOL-BREF domains ranged from moderate (0.54 for social) to good (0.79 for psychological). Test-retest reliability (intraclass correlation) ranged from moderate (0.51 for psychological) to good (0.70 for physical). Associations were confirmed between WHOQOL-BREF domains with DEMQOL-28, Geriatric Depression Scale 15-item version, and Barthel dimensions. With regard to contrasting groups' differences, WHOQOL-BREF scores significantly differentiated between healthy and unhealthy and depressed and nondepressed participants. This study is the first to report on the use of the WHOQOL-BREF in persons with mild-to-moderate dementia. These results indicate that it is a useful tool in assessing these groups, as it includes important dimensions commonly omitted from other dementia measures.

Measuring depression in nursing home residents with the MDS and GDS: an observational psychometric study

BackgroundThe objective of this study was to examine the Minimum Data Set (MDS) and Geriatric Depression Scale (GDS) as measures of depression among nursing home residents.MethodsThe data for this study were baseline, pre-intervention assessment data from a research study involving nine nursing homes and 704 residents in Massachusetts. Trained research nurses assessed residents using the MDS and the GDS 15-item version. Demographic, psychiatric, and cognitive data were obtained using the MDS. Level of depression was operationalized as: (1) a sum of the MDS Depression items; (2) the MDS Depression Rating Scale; (3) the 15-item GDS; and (4) the five-item GDS. We compared missing data, floor effects, means, internal consistency reliability, scale score correlation, and ability to identify residents with conspicuous depression (chart diagnosis or use of antidepressant) across cognitive impairment strata.ResultsThe GDS and MDS Depression scales were uncorrelated. Nevertheless, both MDS and GDS measures demonstrated adequate internal consistency reliability. The MDS suggested greater depression among those with cognitive impairment, whereas the GDS suggested a more severe depression among those with better cognitive functioning. The GDS was limited by missing data; the DRS by a larger floor effect. The DRS was more strongly correlated with conspicuous depression, but only among those with cognitive impairment.ConclusionsThe MDS Depression items and GDS identify different elements of depression. This may be due to differences in the manifest symptom content and/or the self-report nature of the GDS versus the observer-rated MDS. Our findings suggest that the GDS and the MDS are not interchangeable measures of depression.