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Screening for depression in old age

A comparison of the geriatric depression scale and the depression in old age scale

Depressionsscreening im Alter

Ein Vergleich von geriatrischer Depressionsskala (GDS) und Depression im Alter-Skala (DIA-S)

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Abstract

Objective

Since 1996, older patients have been treated in the Nuremberg Geriatric Day Hospital. The geriatric depression scale (GDS) is an obligatory part of the geriatric assessment at admission but its use in the clinical setting has revealed some problems. The aim of the study was to compare the GDS with the depression in old age scale (DIA-S) in terms of applicability and psychometric characteristics.

Methods

As gold standard a semi-structured interview was used to record the depression criteria according to Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Using a sample of 375 patients, sensitivity and specificity as well as positive and negative predictive values were calculated for both screening tests.

Results

No clear superiority of any screening method could be proven. The sensitivity of the DIA‑S in the overall sample was higher than that of the GDS, but the specificity was much lower. In terms of predictive values, there were slight advantages for the GDS. In the sub-samples, poorer values were found in both scales for cognitively impaired or dementia patients with slightly better values for GDS.

Conclusion

The DIA‑S can be used very easily in everyday clinical practice, but no advantages of this method compared to GDS could be demonstrated.

Zusammenfassung

Zielsetzung

Seit 1996 werden ältere Patienten in der Geriatrischen Tagesklinik Nürnberg behandelt. Die geriatrische Depressionsskala (GDS) ist ein obligatorischer Bestandteil des geriatrischen Assessments bei der Aufnahme, aber ihre Anwendung im klinischen Setting hat einige Probleme offenbart. Ziel der Studie war es, die GDS mit der Depression im Alter-Skala (DIA-S) in Bezug auf Anwendbarkeit und psychometrische Eigenschaften zu vergleichen.

Methoden

Als Goldstandard wurde ein semistrukturiertes Interview zur Erfassung der Depressionskriterien nach „Diagnostic and Statistical Manual of Mental Disorders” (DSM-5) verwendet. Anhand einer Stichprobe von N = 375 Patienten wurden Sensitivität und Spezifität sowie positive und negative Vorhersagewerte für beide Screening-Tests berechnet.

Ergebnisse

Es konnte keine eindeutige Überlegenheit einer Screening-Methode nachgewiesen werden. Die Sensitivität der DIA‑S ist in der Gesamtstichprobe höher als die der GDS, die Spezifität ist jedoch deutlich geringer. In Bezug auf die prädiktiven Werte ergaben sich leichte Vorteile für das GDS. In den Teilstichproben fanden sich in beiden Skalen schlechtere Werte für kognitiv eingeschränkte oder demente Patienten mit leicht besseren Werten für die GDS.

Schlussfolgerung

Die DIA‑S ist im klinischen Alltag sehr gut anwendbar, es konnten jedoch keine Vorteile dieses Verfahrens gegenüber der GDS nachgewiesen werden.

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Authors and Affiliations

  1. Klinik für Psychosomatische Medizin und Psychotherapie , Universitätsklinik der Paracelsus Medizinischen Privatuniversität, Klinikum Nürnberg, Prof.-Ernst-Nathan-Str. 1, 90419, Nuremberg, Germany

    Christina Wunner & Christiane Waller

  2. Philosophische Fakultät, Lehrstuhl für Psychologie, Diagnostik, Methodenlehre und Rechtspsychologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen-Nuremberg, Germany

    Christina Wunner & Mark Stemmler

  3. Klinik für Innere Medizin 2, Schwerpunkt Geriatrie, Paracelsus Medizinische Privatuniversität, Klinikum Nürnberg, Nuremberg, Germany

    Johanna Masuch, Markus Gosch & Katrin Singler

  4. Institut für Biomedizin des Alterns, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen-Nuremberg, Germany

    Katrin Singler

Authors
  1. Christina Wunner
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  2. Mark Stemmler
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  4. Markus Gosch
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Corresponding author

Correspondence to Christina Wunner.

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Conflict of interest

C. Wunner, M. Stemmler, J. Masuch, M. Gosch, C. Waller and K. Singler declare that they have no competing interests regarding the submitted manuscript and the reported study.

Ethical standards

All procedures performed in studies involving human participants or on human tissue were in accordance with the 1975 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. The study was approved by the local institutional review board and the ethics committee (Freiburger Ethikkomission International, Nr. 017/1504). Data acquisition was co-financed by the Staedtler-Stiftung, Nuremberg.

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Wunner, C., Stemmler, M., Masuch, J. et al. Screening for depression in old age. Z Gerontol Geriat 55, 44–50 (2022). https://doi.org/10.1007/s00391-021-01949-w

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  • DOI: https://doi.org/10.1007/s00391-021-01949-w

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