Screening for Depression in Old Age With Very Short Instruments: The DIA-S4 Compared to the GDS5 and GDS4

Sonja Heidenblut, Susanne Zank, Sonja Heidenblut, Susanne Zank

Abstract

Purpose of the Study: This article presents a short form of the Depression in old Age Scale with four items (DIA-S4). The diagnostic accuracy of the DIA-S4 was tested and compared to short forms of the Geriatric Depression Scale (GDS5, GDS4). 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: The DIA-S4 had an internal consistency of .70, the GDS5 of .55, and the GDS4 of .58. The test efficiency considering ROC analyses for the DIAS-4 was AUC = .86, for the GDS5 AUC = .78, and for the GDS4 AUC = .74. The best cut-off score for the DIA-S4 was 1.5 with a sensitivity of 87% and a specificity of 68%, for the GDS4 1.5 with a sensitivity of 58% and a specificity of 81%, and for the GDS5 1.5 with a sensitivity of 88% and a specificity of 49%. Conclusion: Based on the data of this study, the DIA-S4 shows better psychometrical qualities than the GDS5 and the GDS4. It can be used as a very short screening scale for depression in old age in research and clinical practice.

Keywords: Depression in old Age Scale (DIA-S4); GDS5); Geriatric Depression Scale (GDS4; assessment; depression; screening.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2020.

Figures

Figure 1.
Figure 1.
ROC curves of the DIA-S4, the GDS5, and the GDS4.

References

    1. AGAST. (1997). Geriatrisches Basisassessment: Handlungsan-leitungen für die Praxis [Geriatric Assessment: Guidelines for clinical practise]. Medizin Verlag.
    1. Beyermann S., Trippe R. H., Bähr A. A., Püllen R. (2013). Mini-Mental-Status-Test im stationären geriatrischen Bereich: Eine evaluation der diagnostischen qualität [Mini-Mental State Examination in geriatrics. An evaluation of diagnostic quality]. Zeitschrift für Gerontologie und Geriatrie, 46(8), 740–747.
    1. Chattat R., Ellena L., Cucinotta D., Savorani G., Mucciarelli G. (2001). A study on the validity of different short versions of the geriatric depression scale. Archives of Gerontology and Geriatrics, 7, 81–86.
    1. D’Ath P., Katona P., Mullan E., Evans S., Katona C. (1994). Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Family Practice, 11(3), 260–266.
    1. Dautzenberg G., Lijmer J., Beekman A. (2020). Diagnostic accuracy of the Montreal Cognitive Assessment (MoCA) for cognitive screening in old age psychiatry: Determining cutoff scores in clinical practice. Avoiding spectrum bias caused by healthy controls. International Journal of Geriatric Psychiatry, 35(3), 261–269.
    1. Deutsche Gesellschaft für Geriatrie. (2019). S1-Leitlinie “Geriatrisches Assessment der Stufe 2” [S1 Guideline “Geriatric assessment step 2”].
    1. DGPPN. (2015). Nationale Versorgungsrichtlinie Unipolare Depression [National Care Guideline for Unipolar Depression].
    1. Folstein M. F., Folstein S. E., McHugh P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12(3), 189–198.
    1. Gantner a., Schubert D., Wolf S., Creps P. (2003). Screening for depression in a geriatric rehabilitation sample. International Journal of Psychiatry in Medicine, 33(4), S.333–341.
    1. Hautzinger M., Hemmeter U., Hirsbrunner T., Holsboer-Trachsler E., Leyhe T., Mall J.F., Mosimann U., Rach N., Trächsel N., Savaskan E. (2018). Empfehlungen für diagnostik und therapie der depression im alter [Therapy recommendations for diagnosis and treatment of depression in old age]. Praxis, 107(3), S.127–144.
    1. Hegeman J. M., Kok R. M., van der Mast R. C., Giltay E. J. (2012). Phenomenology of depression in older compared with younger adults: Meta-analysis. The British Journal of Psychiatry, 200(4), 275–281.
    1. Heidenblut S, Zank S. (2010). Development of a new screening instrument for geriatric depression. The depression in old age scale (DIA-S). Zeitschrift Für Gerontologie und Geriatrie, 43(3), 170–176.
    1. Heidenblut S., Zank S. (2014). Screening for depression with the Depression in Old Age Scale (DIA-S) and the Geriatric Depression Scale (GDS15): Diagnostic accuracy in a geriatric inpatient setting. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 27(1), 41–49.
    1. Helvik A-S., Engedal K., Krokstad S., Stordal E., Selbaek G. (2012). A comparison of depressive symptoms in elderly medical inpatients and the elderly in a population-based health study (the Nord-Trondelag Health Study 3). Nordic Journal of Psychiatry, 66, 189–197.
    1. Horackova K., Kopecek M., Machu V., Kagstrom A., Aarsland D., Bankovska Motlova L., Cermakova P. (2019). Prevalence of late-life depression and gap in mental health service use across European regions. European Psychiatry, 57, 19–25.
    1. Hoyl M. T., Alessi C. A., Harker J. O., Josephson K. R., Pietruszka F. M., Koelfgen M., Mervis J. R., Fitten L. J., Rubenstein L. Z. (1999). Development and testing of a five-item version of the Geriatric Depression Scale. Journal of the American Geriatrics Society, 47(7), 873–878.
    1. Jung Y. E., Kim M. D., Bahk W. M., Woo Y. S., Nam B., Seo J. S., Jang S-H., Sung H-M., Shim I-H., Yoon B-H., Kim J. S., Kwon Y. J. (2019). Validation of the Korean version of the depression in old age scale and comparison with other depression screening questionnaires used in elderly patients in medical settings. Clinical Psychopharmacology and Neuroscience, 17(3), 369–376.
    1. Koenig H. (1997). Differences in psychosocial and health correlates of major and minordepression in medically ill older adults. Journal of the American Geriatrics Society, 45(12), 1487–1495.
    1. Leentjens A. F., Verhey F. R., Lousberg R., Spitsbergen H., Wilmink F. W. (2000). The validity of the Hamilton and Montgomery-Asberg depression rating scales as screening and diagnostic tools for depression in Parkinson’s disease. International Journal of Geriatric Psychiatry, 15(7), 644–649.
    1. Lübke N., Meinck M., von Renteln-Kruse N. (2004). Der Barthel–Index in der Geriatrie. Eine Kontextanalyse zum Hamburger Einstufungsmanual. [The Barthel Index in geriatrics. A context analysis for the Hamburg Classification Manual]. Zeitschrift für Gerontologie und Geriatrie, 37, 316– 326.
    1. Mahoney F. I., Barthel D. W. (1965). Functional evaluation: The Barthel Index. Md State Med J, 14(61–65), 61–65.
    1. Mätzold S., Geritz J., Zeuner K. E., Berg D., Paschen S., Hieke J., . . . Maetzler W. (2019). Functional movement disorders in neurogeriatric inpatients: Underdiagnosed, often comorbid to neurodegenerative disorders and treatable. Zeitschrift für Gerontologie und Geriatrie, 52(4), 324–329.
    1. McCusker J., Cole M., Dufouil C., Dendukuri N., Latimer E., Windholz S., Elie M.(2005). The prevalence and correlates of major and minor depression in older medical inpatients. Journal of the American Geriatrics Society, 53, 1344–1353.
    1. Montgomery S. a., Asberg M. (1979). A new depression scale designed to be sensitive to change. The British Journal of Psychiatry, 134(4), 382–389.
    1. Mottram P., Wilson K., Copeland J. (2000). Validation of the Hamilton depression rating scale and montgomery and asberg rating scales in terms of AGECAT Depression cases. International Journal of Geriatric Psychiatry, 60, 1113–1119.
    1. NCCFMA. (2010). Depression in adults with a chronic physical health problem. British Psychological Society.
    1. Neumann N.-U., Schulte R.-M. (1989). Montgomery and Asberg Depression Rating Scale. Deutsche Fassung [Montgomery and Asberg Depression Ratin Scale. German Version]. Perimed Fachbuch Verlagsgesellschaft.
    1. Otto F., de Wall S. (2019). Inpatient treatment for informal caregivers of relatives suffering from dementia. Zeitschrift Fur Allgemeinmedizin, 2019(11), 462–467.
    1. Pomeroy I., Clark C., Philp I.(2001). The effectiveness of very short scales for depressionscreening in elderly medical patients. International Journal of Geriatric Psychiatry,16, 321–326.
    1. Rashedi V., Rezaei M., Foroughan M., Delbari A. (2016). Validity and reliability of the depression in old age scale (DIA-S) in Iranian older adults. Archives of Gerontology and Geriatrics, 66, 193–197.
    1. Renteln-Kruse W., Ebert D. (2003) Merkmale hospitalisierter geriatrischer Patienten –Zwei Kohorten im Vergleich unter Verwendung des Screenings derArbeitsgemeinschaft Geriatrisches Basisassessment (AGAST) [Characteristics of hospitalized geriatric patients – a comparison of two cohorts using the screening of the Arbeitsgemeinschaft Geriatrisches Basisassessment (AGAST)]. Zeitschrift fürGerontologie und Geriatrie, 36, 223–232.
    1. Sieske L., Janssen G., Babel N., Westhoff T. H., Wirth R., Pourhassan M. (2019). Inflammation, appetite and food intake in older hospitalized patients. Nutrients, 11(9), 1–10.
    1. van Marwijk H. W., Wallace P., de Bock G. H., Hermans J., Kaptein a a, Mulder J. D. (1995). Evaluation of the feasibility, reliability and diagnostic value of shortened versions of the geriatric depression scale. The British Journal of General Practice : The Journal of the Royal College of General Practitioners, 45(393), 195–199.
    1. Weeks S. K., McGann P. E., Michaels T. K., Penninx B. W. J. H. (2003). Comparing various short-form Geriatric Depression Scales leads to the GDS-5/15. Journal of Nursing Scholarship an Official Publication of Sigma Theta Tau International Honor Society of Nursing Sigma Theta Tau, 35(2), 133–137.
    1. World Health Organization. (1992). The ICD-10 classification of mental and behavioural disorders : Clinical descriptions and diagnostic guidelines. World Health Organization;
    1. Xiang X., Danilovich M.K., Noth Tomasino K., Jordan N. (2018). Depression prevalence and treatment among older home health services users in the United States. Archives of Gerontology and Geriatrics, 75, 151–157.
    1. Yesavage J. A., Brink T. L., Rose T. L., Lum O., Huang V., Adey M., Leirer V. O. (1986). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17(1), 37–49.

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