Article type
Year
Abstract
Background: Older adults are vulnerable to mental health problems such as depression. Screening tools are usually used for the identification of persons with depressive symptoms, being the Geriatric Depression Scale (GDS) one of the most widely used instruments in this population. There are short versions of the GDS such as the GDS-4 and GDS-5 that can help for faster detection of this condition.
Objectives: To assess the accuracy of the GDS-4 and GDS-5 for screening depression in older adults.
Methods: During February 2020, we performed a systematic search in PubMed, PsycINFO, Scopus, and Google Scholar; to identify studies that reported diagnostic performance of the GDS-4 or GDS-5, compared to any reference assessment, in older adults from any setting. Two review authors in parallel performed study selection, data extraction according to the inclusion and exclusion criteria, and risk of bias evaluation of the included studies using the QUADAS-2 tool. We performed meta-analyses for sensitivity and specificity and evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The protocol is available at https://bit.ly/2yD1ScZ
Results:
• We identified 202 records, of which 21 studies were included. Seventeen studies evaluated the GDS-4 and eight the GDS-5. Several versions of the GDS-4 and GDS-5 were identified.
• Regarding GDS-4: when comparing different cut-off points, the threshold ≥1 had the highest pooled sensitivity (88%, 95% CI: 84% to 92%) but low specificity (67%, 95% CI: 58% to 75%). In the subgroup analysis, Van Marwijk’s GDS-4 had the best balance between sensitivity (86%, 95% CI: 76% to 96%) and specificity (77%, 95% CI: 67% to 87%).
• Regarding GDS-5: when comparing different cut-off points, the threshold ≥ 2 had the best relation between sensitivity (87%, CI 95%: 81 to 93) and specificity (80%, CI 95%: 74 to 87). In the subgroup analysis, Hoyl’s GDS-5 has the best sensitivity (87%, CI 95%: 80 to 95) and specificity (81%, CI 95%: 73 to 90).
• In general, the certainty of the evidence was very low for sensitivity and specificity of both versions (Table 1).
Conclusions: Among the assessed GDS versions, Hoyl’s GDS-5 with a cut-off point ≥2 had the best performance in sensitivity and specificity.
Patient or healthcare consumer involvement: It is important to make an early diagnosis of depression to start correspondent treatment early. Screening tools for depression with good performance and reduced application time are required.
Objectives: To assess the accuracy of the GDS-4 and GDS-5 for screening depression in older adults.
Methods: During February 2020, we performed a systematic search in PubMed, PsycINFO, Scopus, and Google Scholar; to identify studies that reported diagnostic performance of the GDS-4 or GDS-5, compared to any reference assessment, in older adults from any setting. Two review authors in parallel performed study selection, data extraction according to the inclusion and exclusion criteria, and risk of bias evaluation of the included studies using the QUADAS-2 tool. We performed meta-analyses for sensitivity and specificity and evaluated the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. The protocol is available at https://bit.ly/2yD1ScZ
Results:
• We identified 202 records, of which 21 studies were included. Seventeen studies evaluated the GDS-4 and eight the GDS-5. Several versions of the GDS-4 and GDS-5 were identified.
• Regarding GDS-4: when comparing different cut-off points, the threshold ≥1 had the highest pooled sensitivity (88%, 95% CI: 84% to 92%) but low specificity (67%, 95% CI: 58% to 75%). In the subgroup analysis, Van Marwijk’s GDS-4 had the best balance between sensitivity (86%, 95% CI: 76% to 96%) and specificity (77%, 95% CI: 67% to 87%).
• Regarding GDS-5: when comparing different cut-off points, the threshold ≥ 2 had the best relation between sensitivity (87%, CI 95%: 81 to 93) and specificity (80%, CI 95%: 74 to 87). In the subgroup analysis, Hoyl’s GDS-5 has the best sensitivity (87%, CI 95%: 80 to 95) and specificity (81%, CI 95%: 73 to 90).
• In general, the certainty of the evidence was very low for sensitivity and specificity of both versions (Table 1).
Conclusions: Among the assessed GDS versions, Hoyl’s GDS-5 with a cut-off point ≥2 had the best performance in sensitivity and specificity.
Patient or healthcare consumer involvement: It is important to make an early diagnosis of depression to start correspondent treatment early. Screening tools for depression with good performance and reduced application time are required.