Screening Performance of the 15-Item Geriatric Depression Scale in a Diverse Elderly Home Care Population
Open accessAbstract
Objective To empirically evaluate the psychometric properties of the 15-item Geriatric Depression Scale (GDS-15); determine the optimal cutoff points and screening performance for the detection of major depression; and examine differential item functioning (DIF) to determine the variability of item responses across sociodemographics in an elderly home care population.Design A secondary analysis of data collected from a random sample study.Setting Homebound subjects newly admitted over a 2-year-period to a large visiting nurse service agency in Westchester, New York.Participants Five hundred twenty-six subjects over age 65, newly admitted to home care for skilled nursing.Measurements Major depression was diagnosed using both patient, Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and best estimate procedures. Self-report measures included the GDS-15, activities of daily living (ADL), instrumental ADL, and pain intensity. Cognitive impairment was assessed using the Mini-Mental State Examination and medical morbidity using the Charlson Comorbidity Index.Results Optimal cutoff (5) yielded sensitivity 71.8% and specificity of 78.2%, however, the accuracy of the GDS-15 was not influenced by severity of medical burden. Persons with a cluster of ailments were twice as likely (Adj odds ratio = 2.47; 95% confidence interval = 1.49-4.09) to be diagnosed with depression. DIF analyses revealed no variability of item responses across sociodemographics.Conclusion Main findings suggest that the accuracy of the GDS-15 was not influenced by severity of clinical or functional factors, or sociodemographics. This has broad implications suggesting that the very old, ill, and diverse populations can be appropriately screened for depression using the GDS-15.
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The GDS has been used extensively to measure depressive symptoms among older adults.
“The GDS has been used extensively to measure depressive symptoms among older adults [42].”
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- Authors
- Marc, L. G., Raue, P. J., & Bruce, M. L.
- Affiliations
- Cambridge Health Alliance (US)
- Corresponding author
- Marc, Linda G.
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2008-11
- Volume
- 16
- Issue
- 11
- Pages
- 914-921
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC2676444
- OpenAlex
- W2036558184
- Cited by
- 320
- References
- 41
- Citations by year
- 2026: 14 · 2025: 19 · 2024: 16 · 2023: 20 · 2022: 7 · 2021: 27 · 2020: 26 · 2019: 25 · 2018: 28 · 2017: 29 · 2016: 21 · 2015: 29 · 2014: 17 · 2013: 15 · 2012: 8
- FWCI
- 6.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH082425, T32MH067555, T32 MH19132, R24MH064608, R01 MH 56482, K23MH069784, R01MH056482, T32MH019132)
- National Institute on Minority Health and Health Disparities (L60 MD002421)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Health and Well-being Studies
- Keywords
- Geriatric Depression Scale, depression screening, major depressive disorder, home care, older adults, differential item functioning, cut-off values, sensitivity and specificity, comorbidities, home-visit nursing, psychometric properties
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Cognition Disorders, Depressive Disorder, Major, Major Depressive Disorder, Female, Home Care Services, Humans, Interview, Psychological, Male, Mass Screening, Neuropsychological Tests, New York, Psychiatric Status Rating Scales, Psychometrics, Surveys and Questionnaires, Sensitivity and Specificity, Severity of Illness Index, Geriatric Assessment, Logistic Models, Homebound Persons, Diagnostic and Statistical Manual of Mental Disorders
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