The Diagnostic Accuracy of Brief and Ultra-brief Versions of the Geriatric Depression Scale: a Meta-analysis

Abstract

Introduction: Depression in older adults is often under-diagnosed and consequently undertreated, despite association with higher rates of morbidity and mortality, increased healthcare utilisation and greater economic cost compared to younger populations. Better identification will be imperative in the future because of the estimated growth in the older adult population. Screening could improve identification; a well-known screening tool tis the Geriatric Depression Scale (GDS). Objective: To evaluate the diagnostic accuracy of the brief GDS-15 and ultra-brief versions in the detection of major depression. Method: Seven electronic databases and unpublished literature were searched, using predefined criteria, from 1982 to April 2014. Primary study quality was assessed using the QUADAS-2. Pooled diagnostic performance data was calculated using bivariate meta-analysis. Subgroup and sensitivity analyses were pre-planned. Heterogeneity was explored through meta-regression. Results: Of 6635 records identified 32 studies were included. Meta-analyses were possible for the GDS-1, GDS-4 and GDS-15. For the GDS-15, at the recommended cutoff score of 5, the diagnostic odds ratio was highest in a community setting and for older adults aged ≤69 years. A cutoff score of 4, however, provided better diagnostic accuracy. Diagnostic data was less favourable when depression prevalence was ≥10%. Better diagnostic properties were found in non-Western countries. Meta-regression revealed country and language were predictive of diagnostic accuracy. Conclusions: Further research is needed to explore diagnostic properties of ultra-brief GDS versions. GDS-15 findings suggest selective reporting of cutoff scores, which requires cautious interpretation and a need for greater methodological rigor in primary studies.

The association between depression and sexual satisfaction among Malay elderly in Malaysia

“…GDS was specifically developed for uses among elderly and was reported to have satisfactory construct validity and reliability (Teh and Hasanah, 2004). For this study, a cut off value of greater than 5 is indication of depression (Pocklington et al., 2015).…”

Prevalence and determinants of depression among community- dwelling older adults with chronic diseases

“…A score of 0 to 5 was accepted as a normal emotion, while a score of more than 5 suggested depression. Cut off point of 5 was selected based on the review of 32 studies related to the GDS scoring [21]. The reliability of the Malay GDS-15 was high in this current study, with a Cronbach alpha value of 0.84.…”