Academic literature on the topic 'Geriatric Depression Scale'

103 college students took the Geriatric Depression Scale and Center for Epidemiological Studies Depression Scale along with five measures of life satisfaction. The correlation between scores on the first scales was .66. Both depression scales had moderate negative correlations (−.34 to −.71) with each measure of life satisfaction. However, on every measure of life satisfaction, the correlation with scores on the Geriatric Depression Scale was higher than with those on the CES-Depression Scale.

Purpose of the study. The Depression in Old Age Scale (DIA-S), a new screening tool for geriatric depression, was designed to be both practical and appropriate for use with medically ill geriatric patients. The diagnostic accuracy of the DIA-S and the short form of the Geriatric Depression Scale (GDS15) were tested and compared. Methods. Using the Montgomery and Asberg Depression Rating Scale (MADRS) as gold standard, the scales were validated with a sample of N = 331 geriatric inpatients. Results. ROC curves, AUC outcomes, sensitivity and specificity, and logistic regression models for impact factors on misclassification rates indicate good psychometrical qualities of the DIA-S, whereas the validity of the GDS15 was lower.

Purpose Geriatric issues in cancer are becoming prominent. Depression is a significant concern for both the elderly and patients with cancer, yet identifying depression in these patients is difficult and often leads to under-recognition. We conducted a systematic review to determine which depression instruments are appropriate for use in geriatric patients with cancer. Methods We identified the most commonly used self-report depression instruments. We then used the criteria established in the US Food and Drug Administration Draft Guidance on Patient-Reported Outcome Measures to determine the extent of validation evidence of these measures in geriatric cancer populations. Finally, we determined which instruments captured depressive symptoms that are common among elderly patients with cancer. Results Eight measures were selected as the most commonly used instruments. These were the Beck Depression Inventory-II, Brief Symptom Inventory-18, Center for Epidemiologic Studies–Depression Scale, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Patient Health Questionnaire-9, Profile of Mood States–Short Form, and Zung Self-Rating Depression Scale. Many have been validated for use with geriatric adults and patients with cancer; however, data addressing content validity and responder definition were lacking. To date, there is no validation information for geriatric patients with cancer. Furthermore, symptom profile analysis revealed that these measures do not identify many symptoms signaling depression in geriatric patients with cancer. Conclusion The validation evidence for use of common depression instruments in geriatric patients with cancer is lacking. This, and the possibility that these measures may not assess common depressive symptoms in geriatric patients with cancer, questions the adequacy of these scales in this population.

Depression in the elderly is more common than once thought, especially in nursing home settings, where as many as 25% of residents can exhibit signs and symptoms of depression. Depression in the elderly can have a significant impact on overall health and desired outcome. The depressed elderly patient has been shown to have worsened prognosis of concomitant medical conditions, increased use of health care, decreased recovery time, and more likelihood to experience accelerated physical deterioration. Suicide represents the most serious complication of depression of the older depressed individual. The elderly are at a disproportionate risk for suicide attempts and are more likely to be successful. Diagnosis should be made using Diagnostic and Statistical Manual of Mental Disorders(4th ed.) (DSMIV) criteria, and clinicians should use standardized rating scales such as the Geriatric Depression Scale to assist in monitoring the severity of depressive symptoms and the efficacy of antidepressant treatment. Several treatment options are available to the clinician and include psychotherapy, electroconvulsive therapy, older antidepressants such as the tricyclics, and newer more tolerable therapies such as the serotonin reuptake inhibitors. Drug therapy should be individualized and should take into account the pharmacokinetic and pharmacodynamic changes that are associated with normal aging.

The recognition and diagnosis of elderly depression has been the focus of much research over the last 20 years (Brink, 1982; Goodstein, 1985; Klerman, 1983). One problem in diagnosing depression in the elderly has been adequate assessment devices that are sensitive, specific, and predictable with this population (Yesavage et al., 1983). One assessment device developed specifically for the elderly is the Geriatric Depression Scale (GDS) (Brink et al., 1982;Yesavage et al., 1983). This depression scale has yielded high reliability and validity with other self-rating depression scales. In recent research a Short Form Geriatric Depression Scale was produced containing 15 items, all from the original Long Form GDS. A problem with the Short Form involves the lack of research concerning its construct validity. The purpose of the present study was to demonstrate that the Short Form Geriatric Depression Scale does measure depression in the elderly, and therefore, does possess construct validity. To accomplish this task, it was believed that if significant correlations could be identified between various psychosocial variables highly associated with depression in the elderly and the Short Form GDS, validity could be established. The five psychosocial variables chosen: gender differences, physical/health problems, insufficient social support, marital status, and socioeconomic status (finances), have all been shown to be highly related-to depression in the elderly.The information used for this project was gathered from a survey questionnaire developed by the Institute of Gerontology at Ball State University in Muncie, Indiana. The survey questionnaire was sent to over 5,000 randomly selected elderly in the state of Indiana ranging in age from 60 to 85. Of the approximately 5,000 surveys, 2,979 were completed and returned. The survey incorporated questions concerning the five psychosocial variables reviewed and a modification of the Short Form GDS.In order to test the various hypotheses of the study, several analyses were conducted. Based upon the outcome of these analyses, it was concluded that the Short Form Geriatric Depression Scale does possess construct validity. It was also concluded that the Short Form Geriatric Depression scale does assess depression in the elderly and thus is a valid instrument to use in the assessment of depression with the elderly adult.Based upon the information obtained from the survey following hypotheses were supported:a. Elderly individuals with physical disabilities and/or health related problems had higher total GDS scores on the Short Form. b. A positive relationship was found between physiological problems in the elderly and total GDS score.c. Elderly individuals having no social support system had higher total GDS scores on the Short Form.d. A negative relationship existed between an elderly individual's social support system and total GDS score.e. Elderly widows and widowers produced higher total GDS scores than married elderly.f. Elderly individuals with low economic status had higher total GDS scores than elderly individuals with high economic status.
Department of Counseling Psychology and Guidance Services

The Geriatric Depression Scale (GDS) was originally designed as a measure for screening depression among elderly medical patients. Although this instrument is well validated among a general medical population, it has never been evaluated with specific regard to cardiac patients, the largest single group of medical patients over 40 years of age. A general cardiac sample of 655 patients completed the GDS within 10 weeks of the cardiac event. Exploratory factor analyses were conducted on the main sample, then on several subgroups of participants with regard to diagnostic category, gender, and age. The GDS generally produces factor structures with several symptom domains with a high rate of total variance. The myocardial infarction group endorsed general symptoms of depression whereas the coronary artery bypass graft group reported greater levels of despair regarding their condition. Overall, males primarily reported agitation and hopelessness while females reported symptoms of depressed mood.

Early detection of Alzheimer's disease (AD) and related dementias in the elderly is critical for improving treatment methods and is a necessary component for improving public health interventions. One of the earliest and most common behavioral syndromes of AD is apathy and is associated with executive dysfunction. Apathy in AD is often misdiagnosed as depression due to an overlap in symptoms. Studies that have found depression to be associated with executive dysfunction have not always controlled for the presence of apathy. The Geriatric Depression Scale (GDS) is a widely used instrument designed to assess depression in the elderly. This study utilized the GDS and a set of standard neuropsychological instruments to investigate the relationship between apathy, depression, and executive functions in individuals with AD and related dementias. The first objective of this study was to determine if apathy has a greater impact on executive functions compared to depression in AD and related dementias. The second objective was to determine the effectiveness of the GDS as a screen for apathy. The results of the analyses did not support the hypotheses. However, exploratory analyses suggested a possible non-linear relationship with apathy and various levels of dementia severity. Exploratory analysis also suggested mean levels of endorsement for apathy varied by diagnosis. Further research is warranted to investigate this relationship and the GDS endorsement patterns for caregivers regarding their impression of the demented individual.

Depression is poorly recognised, under-assessed and under-treated in patients receiving palliative care for a life-limiting illness. There are barriers to assessment and diagnosis, and limited access to specialist clinicians who might assist in these complex assessments and who could provide options for treatment. The three studies presented, using different research methodologies, and using both qualitative and quantitative analysis, seek to clarify these issues and to provide some solutions. A questionnaire was sent to all Palliative Care Services (PCS) in Australia. Questions included what part specialist psychological clinicians played in multi-disciplinary team meetings and in the treatment or coordination of patient care. Very few PCS used a valid screening instrument for psychological distress and very few had regular support from a psychiatrist or psychologist. Many did not have access to social work support. There are two competing issues with regard to recognising and assessing depression in palliative populations. A rapid reliable screen that points to a likely problem would be useful, but also there is a need to understand something of the patient experience of depression. In the second study, the one- and two-item screening instruments widely used in palliative care are examined and limitations that have been found in other settings are confirmed. A new novel screening tool is developed from this data and tested empirically. This algorithm is short, has good psychometric properties and is validated for an Australian palliative care population. Depending on the response pattern it is possible to identify that a particular patient has significant symptoms of depression by asking between one and four questions. Professional carer and patient acceptability of the questions is high. The understanding of the experience and symptom profile of depression in Australian palliative care patients is addressed in the third study. Patients and family carers were recruited prospectively from palliative care and oncology ambulatory clinics of two teaching hospitals in an Australian capital city. The Geriatric Depression Scale (GDS) was administered to the patient and the Collateral Source version of this instrument was asked of the carer. A subset of this sample completed the measures twice. The results using this 30-item scale were then compared with all the known previously published short versions of this scale. Two short forms met as many psychometric criteria as the longer forms. None of the versions of the GDS showed sufficiently high correlations between carer-completed and patient-completed forms. The frequency of symptoms was also assessed. Patients more frequently reported fatigue and anhedonia than depressed affect. Despite many screening instruments being available for depression, their use is limited in Palliative Care Services. Although these studies have validated several options for Australian palliative care patients, the issues behind the low uptake rates for screening have not been resolved. The final chapter of this thesis constructs known and potential barriers into a logical structure and then offers some solutions to improve access to mental health professionals by considering service models and applying this theory to the problem of depression and its assessment in palliative care populations.

The purpose of the current study was to explore the relationship between cognitive status and depression in a sample of geriatric patients. Participants included 282 geriatric patients ranging in age from 65 to 96 years who were classified according to diagnosis as: DAT, VaD, MCI, and Norm. All were referred for neurocognitive testing from the Geriatric Assessment Program (GAP) at the University of North Texas Health Science Center (UNTHSC) in Fort Worth, Texas. This study sought to identify factor structures for two versions of the GDS using a geriatric sample of cognitively impaired and intact patients. It then compared these factors to each other to determine whether the GDS-15 is truly a shorter version of the GDS-30. These were then compared to a previously determined factor structure. This study explored whether the four-factors of the GDS-30 are able to differentiate cognitive diagnostic groups. Further, this study sought to identify whether the severity of cognitive decline impacted GDS factor score for each of the cognitively impaired groups. Results revealed a two-factor model of the GDS - 15 and a four-factor model with the GDS - 30. The GDS-15 factors did not differ from the first two factors of the GDS-30. Comparison between the GDS-30 factor structure and that reported by Hall and Davis (in press) revealed no significant differences despite the inclusion of a normal, non-demented group in the current study. Comparisons of subscale scores revealed that DAT patients tended to score lower than the other groups on all but the cognitive impairment subscale. Severity level analyses indicated that as severity of deficits increases, awareness of deficits decreases. This study found that although the GDS-30 is a good screening tool for depression in geriatric patients, it is not particularly useful in differentiating cognitive status group. Also, the GDS-15 was not found to be a good substitute for the GDS-30.

Background The prevalence and incidence of stroke are known to increase with age, which, combined with demographic change, means that very old patients with stroke are a growing patient group. Risk factors for incident stroke among very old people have not been widely investigated. The impact of depression on mortality in very old people who have had a stroke also remains unclear.  The aim of this thesis was to investigate the risk factors for incident stroke, the epidemiology of stroke and depression, and the consequences of having had a stroke regarding the risk of depression and mortality among very old people. Methods A randomly selected half of 85-, all 90-, and all ≥95-year-olds in certain municipalities in Västerbotten County, Sweden, and Pohjanmaa County, Finland were targeted in a population-based cohort study from 2000-2012. The 65-, 70-, 75-, and 80-year-olds in all the rural and random samples from the urban municipalities in the same counties were furthermore targeted in a survey in 2010. In the cohort study patients were assessed in their homes, by means of the 15-item Geriatric Depression Scale (GDS-15) and other assessment scales, as well as blood pressure measurements, several physical tests, and a review of medical diagnoses appearing in the medical charts. Incident stroke data were collected from medical charts guided by hospital registry records, cause of death records, and reassessments after 5 years. Depression was defined as a GDS-15 score ≥5. A clinical definition of all depressive disorders, based on assessment scale scores and review of medical charts was also used. A specialist in geriatric medicine evaluated the diagnoses. The survey included yes/no questions about stroke and depression status, and the 4-item Geriatric Depression Scale. Associations with mortality and incident stroke were tested using Cox proportional-hazard models.  Results In the ≥85-year-olds examined in 2005-2007 (n=601), the stroke prevalence was 21.5%, the prevalence of all depressive disorders was 37.8% and stroke was independently associated with depressive disorders (odds ratio 1.644, p=0.038). The prevalence of depression according to GDS-15 scores was 43.2% in people with stroke compared with 25.0% in people without stroke (p=0.001). However, in ≥85-year-olds examined in Sweden from 2000-2012 (n=955), from all past data collections in the study, depression was not independently associated with incident stroke.  In ≥65-year-olds who responded to a survey in 2010 (n=6098), the stroke prevalence rose with age from 4.7% among the 65- to 11.6% among the 80-year-olds (p<0.001). The prevalence of depression rose from 11.0% among the 65- to 18.1% among the 80-year-olds (p<0.001). In the group with stroke, depression was independently associated with dependence in personal activities of daily living and having a life crisis the preceding year, while in the non-stroke group, depression was independently associated with several additional demographic, social and health factors. In ≥85-year-olds examined in 2005-2007 with valid GDS-15 tests (n=452), having had a stroke was associated with increased 5-year mortality [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.15-2.03]. Having had a stroke and depression was associated with increased 5-year mortality compared with having only stroke (HR 1.90, 95% CI 1.15-3.13), having only depression (HR 1.59, 95% CI 1.03-2.45), and compared with having neither stroke nor depression (HR 2.50, 95% CI 1.69-3.69). Having only stroke without a depression did not increase mortality compared with having neither stroke nor depression. In ≥85-year-olds examined in Sweden from 2000-2012 (n=955), from all past data collections in the study, the stroke incidence was 33.8/1000 person-years during a mean follow-up period of about three years. In a comprehensive multivariate model, atrial fibrillation (HR 1.85, 95% CI 1.07–3.19) and higher systolic blood pressure (SBP; HR 1.19, 95% CI 1.08–1.30 per 10-mmHg increase) were associated with incident stroke overall. In additional multivariate models, diastolic blood pressure (DBP) ≥90 mmHg (HR 2.45, 95% CI 1.47–4.08) and SBP ≥160 mmHg (v. <140 mmHg; HR 2.80, 95% CI 1.53–5.14) were associated with incident stroke. Conclusion The prevalence of both stroke and depression increased with age, and rates were especially high among very old people. Having had a stroke was independently associated with a higher prevalence of depression among very old people, however, depression was not independently associated with a higher incidence of stroke. Having had a stroke was associated with increased all-cause mortality among very old people, but only among those who were also depressed. High SBP (≥160 mmHg), DBP (≥90 mmHg) and atrial fibrillation were the only consistent independent risk factors for incident stroke among very old people.
I västvärlden inklusive Sverige så ökar gruppen av människor som uppnår åldern 80 år eller äldre. Människorna som uppnår denna mycket höga ålder har en hög förekomst av kardiovaskulära riskfaktorer, har ofta flera samtidiga sjukdomar och ofta funktionsnedsättningar. Medicinska behandlingsåtgärder är ofta mindre effektiva och förknippade med biverkningar i åldersgruppen. Stroke är en sjukdom som beror på skada av hjärnvävnad till följd av minskad blodtillhörsel till delar av hjärnan. Det är känt att såväl förekomsten av och insjuknandet i stroke ökar med stigande ålder. Den som drabbas av stroke löper risk att få en bestående funktionsnedsättning och att dö i förtid. En vanlig komplikation efter att ha drabbats av stroke är nedstämdhet eller depression. Vetenskapliga studier om stroke har tidigare negligerat mycket gamla människor, vilket i takt med den pågående demografiska utvecklingen framstått som allt mer orimligt. Det är ej helt klarlagt vilka riskfaktorer som leder till att insjukna med stroke i mycket hög ålder. Överdödligheten förknippad med att drabbas av depression efter stroke är också oklar i åldersgruppen. Det är också oklart vad som skiljer depression efter stroke från depression bland den övriga befolkningen av åldrade människor. Den populations-baserade kohortstudien GErontologisk Regional DAtabas (GERDA) inleddes år 2000 för att kartlägga faktorer förknippade med gott åldrande bland mycket gamla människor. Hälften av 85-åringarna, alla 90-åringar och alla ≥95-åringar i utvalda kommuner i Västerbotten erbjöds att delta i studien. Därefter har återbesök hos tidigare deltagare i sina nya åldersgrupper och rekrytering av nya deltagare genomförts vart femte år. Studien utvidgades med utvalda kommuner i Österbotten, Finland vid den första femårsuppföljningen. Datainsamlingen i studien bestod av demografiska frågor, skattningsskalor, blodtrycksmätning och kognitiva test genomförda vid ett hembesök i deltagarens hem, samt genomgång av journalhandlingar. År 2010 skickades även en enkät ut till 65-, 70-, 75- och 80-åringar i alla kommuner i Västerbotten och Österbotten. Enkäten innehöll frågor om demografi, hälsa, sjukdomar och intressen. Bland deltagarna i kohortstudien bestämdes förekomsten av tidigare stroke baserat på genomgång av journaluppgifter och uppgifter från hembesöken. Förekomsten av depression bestämdes baserat på poängsättning från en validerad skattningsskala för depression, samt baserat på en sammanvägning av journaluppgifter och skattningsskalor. En specialist i geriatrik fattade det slutliga beslutet om diagnoser. Insjuknande i stroke bestämdes baserat på journalgenomgång av individer med stroke-relaterade diagnoskoder i sjukhusregistret, i dödsorsaksregistret eller uppgift om stroke vid femårsuppföljningen i studien. Bland deltagarna i enkätstudien bestämdes förekomsten av tidigare stroke baserat på självrapportering, och förekomsten av depression bestämdes baserat på en sammanvägning av självrapportering och en skattningsskala för depression.  Förekomsten av stroke i enkätstudien steg med ålder, från 4.7% bland 65-åringar till 11.6% bland 80-åringar. Förekomsten av stroke var omkring 20% bland ≥85-åringar, med minimal variation mellan 85-, 90- och ≥95-åringar. Förekomsten av depression var högre bland dem med stroke jämfört med de övriga deltagarna, både gällande den sammavägda diagnosen och baserat endast på poängsättning. Stroke och sömnproblem var oberoende associerade med depression. Bland ≥65-åringar i enkätstudien var funktionsnedsättning och genomgången livskris associerade med depression hos dem med en tidigare stroke. Bland deltagare utan stroke var ett antal ytterligare externa faktorer, inklusive subjektiv upplevelse av dålig ekonomi och att inte ha någon att anförtro sig till, associerade med depression. Både stroke och depression var associerade med ökad dödlighet bland ≥85-åringar. De med stroke utan depression hade en dödlighet i linje med normalbefolkningen utan stroke eller depression. Förekomsten av samtidig stroke och depression var associerad med högre dödlighet än normalbefolkningen, jämfört med dem med enbart stroke eller enbart depression. Högt systoliskt blodtryck (≥160 mmHg), högt diastoliskt blodtryck (≥90 mmHg) och förmaksflimmer var oberoende riskfaktorer för att insjukna i stroke bland ≥85-åringarna. Sambandet mellan blodtryck och strokerisk försvagades ej hos människor med kognitiv eller funktionell nedsättning. Tidigare stroke, hjärtsvikt, kognitiv nedsättning, näringsbrist, depressiva symtom och låg gånghastighet var också associerade med att insjukna i stroke, men ej oberoende av varandra. Sammanfattningsvis så stiger förekomsten av stroke med åldern och är särskilt hög bland mycket gamla människor. Depression är betydligt vanligare hos mycket gamla människor med stroke, även justerat för störningsfaktorer. Depression är främst associerat med funktions-nedsättning hos människor med stroke, men med ett större antal externa faktorer hos människor utan stroke. Mycket gamla människor med stroke har särskilt hög dödlighet om de samtidigt är deprimerade, men en dödlighet i linje med normalbefolkningen om de inte är deprimerade. Högt systoliskt och diastoliskt blodtryck samt förmaksflimmer är viktiga och behandlingsbara orsaker till att drabbas av stroke i mycket hög ålder.

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

Changes in mood and/or cognition are common complaints in the elderly population. This chapter uses case studies to illustrate insights to make clinical assessment more efficient. These include assessing for cognitive impairment when depression is present and vice versa, being mindful of assuming that patients reporting cognitive difficulties are “worried well,” avoiding overreaction to very mild symptoms, assessing the four key cortical cognitive domains (amnesia, aphasia, apraxia, agnosia), assessing for subcortical dysfunction, assessing Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), and understanding that depression in the elderly often presents with atypical symptoms. Brief cognitive instruments which can improve assessment include the Mini Mental State Exam (MMSE), Montreal Cognitive Assessment (MoCA), Patient Health Questionnaire (PHQ), Clock Drawing Test (CDT), and the Mini Cog. Brief depression instruments include the Geriatric Depression Scale (GDSS), and Cornell Scale for Depression in Dementia (CSDD).

ABSTRACT Background: Elderly interpreted as a period of decline in physical and psychological functioning. This will have a negative effect on stressful situation and result in depression. This depressive state has an impact on the implementation of daily activities. One cognitive therapy method that can be applied to treat depressive disorders is to do a brain gym. Brain gym strives to activate the left and right brain optimally with simple movements and accompanied by music. This study aimed to determine the effect of the brain gym on depression levels in the elderly. Subjects and Method: This was an experimental one group pre-test and post-test design conducted at Tegalgiri Village, Nogosari, Boyolali, Central Java, from October to November, 2017. A total sample of 27 elderlies was selected by quota sampling. The dependent variable was depression. The independent variables (intervention) were brain gym with eight times and each session lasting 10-15 minutes. The data were collected by Geriatric Depression Scale (GDS) version 15. The depression score uses a numerical scale. The data were analyzed by pairwise comparison test. Result: Depression before intervention (Mean= 7.96) after the intervention (Mean= 6.45). The results of the comparison test obtained (r= 0.89; 95% CI= 1.23 to 1.74; t= 11,98, p< 0.001, df= 26). Conclusion: There are different levels of depression before and after the intervention. Brain gym has an influence on the level of depression in the elderly in Tegalgiri Village, Nogosari Boyolali. Encourage local health cadres to further activate integrated healthcare center for the elderly, one of the activities is gymnastics, including a brain gym. Keywords: Elderly, Brain Gym, Depression Correspondence: Rita Untari. School of Health Polytechnic, Surakarta, Jl. Letjen Soetoyo Mojosongo, Surakarta. Email: ritauntari@gmail.com. Mobile: 08164278544 DOI: https://doi.org/10.26911/the7thicph.05.19