scholarly journals Unrecognized geriatric depression in the emergency Department of a Teaching Hospital in Nepal: prevalence, contributing factors, and metric properties of 5 item geriatric depression scale in this population

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
Abha Shrestha ◽  
Barbara Kamholz
Keyword(s):  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Geriatric Depression ◽  
Multinomial Regression ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Sensitivity Specificity ◽  
Spearman’S Correlation

Abstract Background Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to identify the frequency of unrecognized geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS. Methods This was a cross-sectional study of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into “no”, “mild-moderate” and “severe” depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviors were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach’s alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman’s correlation, receiver operating characteristic curve, and kappa coefficient. Results Two hundred eighty patients were enrolled with an overall prevalence of unrecognized depression of 45.7% [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived “heart and mind” disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman’s correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach’s alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach’s alpha to 0.623. Conclusions Unrecognized geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.

scholarly journals Unrecognized Geriatric Depression in the Emergency Department of a Teaching Hospital in Nepal: Prevalence, Contributing Factors, and Metric Properties of 5 item Geriatric Depression Scale in this Population

2020 ◽  
Author(s):  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
Abha Shrestha ◽  
Barbara Kamholz
Keyword(s):  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Geriatric Depression ◽  
Multinomial Regression ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Sensitivity Specificity ◽  
Spearman’S Correlation

Abstract Background: Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to identify the frequency of unrecognized geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS.Methods: This was a cross-sectional study of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into “no”, “mild-moderate” and “severe" depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviors were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach’s alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman’s correlation, receiver operating characteristic curve, and kappa coefficient.Results: 280 patients were enrolled with an overall prevalence of unrecognized depression of 45.7 % [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived “heart and mind” disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman’s correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach's alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach’s alpha to 0.623.Conclusions: Unrecognized geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.

scholarly journals Geriatric Depression in the Emergency Department of a Teaching Hospital in Nepal: Prevalence, Contributing Factors, and Metric Properties of 5 item Geriatric Depression Scale in this Population

2020 ◽  
Author(s):  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
Abha Shrestha ◽  
Barbara Kamholz
Keyword(s):  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Geriatric Depression ◽  
Multinomial Regression ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Sensitivity Specificity ◽  
Spearman’S Correlation

Abstract Background Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to determine the prevalence of geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS. Methods This was a cross-sectional study with convenience sampling of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into “no”, “mild-moderate” and “severe" depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviour were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach’s alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman’s correlation, receiver operating characteristic curve, and kappa coefficient. Results 280 patients were enrolled with an overall prevalence of depression of 45.7% [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived “heart and mind” disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman’s correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach's alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach’s alpha to 0.623. Conclusions Geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.

scholarly journals Unrecognized Geriatric Depression in the Emergency Department of a Teaching Hospital in Nepal: Prevalence, Contributing Factors, and Metric Properties of 5 item Geriatric Depression Scale in this Population

2020 ◽  
Author(s):  
Roshana Shrestha ◽  
Anmol Purna Shrestha ◽  
Abha Shrestha ◽  
Barbara Kamholz
Keyword(s):  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Geriatric Depression ◽  
Multinomial Regression ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Sensitivity Specificity ◽  
Spearman’S Correlation

Abstract Background: Depression is prevalent but poorly recognized in the Emergency Department (ED). We aimed to identify the frequency of unrecognized geriatric depression and its possible determinants in the ED using the 15-item geriatric depression scale (GDS). We also aimed to explore the performance of the shorter, five-item GDS as compared to the 15-item GDS.Methods: This was a cross-sectional study of the ED patients ≥ 60 years. The previously validated Nepali version of GDS-15 screened the sample into “no”, “mild-moderate” and “severe" depression using cutoff values of 4/5, and 8/9 respectively. Demographic and socioeconomic factors, comorbidities and health seeking behaviors were studied and the relation was assessed with binary (Chi-square and Kruskal-Wallis test) and multinomial regression analysis. The performance of GDS-5 was compared with the GDS-15 as standard. Cronbach’s alpha was calculated to investigate reliability. Validity was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, Spearman’s correlation, receiver operating characteristic curve, and kappa coefficient. Results: 280 patients were enrolled with an overall prevalence of unrecognized depression of 45.7 % [104 (81.3%) mild-moderate depression, and 24 (18.8%) severe depression]. The mean age of the sample was 71.36 with female predominance (61%), and 82.5% were illiterate. In the binary analysis, those who had more pain, visited the ED more often, had musculoskeletal diseases and sleep problems, mobility problems, visited local healers previously, and who reported self-perceived “heart and mind” disease showed statistically significant differences among the three categories. In multinomial regression analysis, visits to local healers, sleep problems and frequency of pain were significantly related to depression. The sensitivity, specificity, area under curve and Spearman’s correlation of GDS-5 were 75.8%, 96%, 0.919, and 0.827 respectively. Cronbach's alpha for GDS-5 was low (0.416), therefore a new version was proposed which improved the sensitivity to 90.6% and Cronbach’s alpha to 0.623. Conclusions: Unrecognized geriatric depression was highly prevalent which urges the need for ED-based interventions for screening and referral. The proposed brief GDS-5 correlated well with the GDS-15 with better validity and internal reliability and offers a more expeditious form of screening for geriatric depression in emergency settings in Nepal.

scholarly journals Nepali Version of Geriatric Depression Scale-15 – A Reliability and Validation Study

2020 ◽  
Vol 17 (4) ◽  
pp. 506-511 ◽  
Author(s):  
Ajay Risal ◽  
Eliza Giri ◽  
Oshin Shrestha ◽  
Sabina Manandhar ◽  
Dipak Kunwar ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Internal Consistency ◽  
Predictive Value ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Valid Instrument ◽  
Sensitivity Specificity

Background: Geriatric depression is a significant problem in both the developed and the developing world. To identify this condition, Geriatric Depression Scale has been used in different languages and cultural settings; it has proved to be a reliable and valid instrument. However, the Geriatric Depression Scale-15 version in Nepali has so far not been validated.Methods: The original 15-item version of the Geriatric Depression Scale-15 was translated into Nepali and administered by trained nurses to a target sample aged ?60 years at Dhulikhel Hospital (n=106). Subsequently, the participants were blindly interviewed by a consultant psychiatrist for possible geriatric depression according to the ICD-10 criteria. Cronbach’s alpha checked the reliability. Validity was assessed for three different cut-off points (4/5, 5/6, and 6/7); the related sensitivity, specificity, positive predictive value, and the negative predictive value of the scale were estimated.Results: The mean participant age was 68.1 (±7.2); males and females, 50.9% and 49.1%, respectively. Cronbach’s alpha was 0.79.The optimal cut-off point was found to be 5/6 with sensitivity and specificity 86.3% and 74.5%, respectively. Conclusions: Using a standard statistical protocol, a reliable and valid Geriatric Depression Scale-15-Nepali was developed with an adequate internal consistency and an optimal balance between sensitivity and specificity at cut-off point 5/6.The Geriatric Depression Scale-15-Nepali can serve as an appropriate instrument for assessing geriatric depression in epidemiological research as well as in primary health care settings in Nepal.Keywords: Geriatric depression; internal consistency; sensitivity; South Asia; specificity.

scholarly journals Psychometric Properties of Geriatric Depression Scale (Malay Version) in Elderly with Cognitive Impairment

2021 ◽  
Vol 28 (3) ◽  
pp. 97-104
Author(s):  
Azlina Wati Nikmat ◽  
Zahir Izuan Azhar ◽  
Norley Shuib ◽  
Nurul Azreen Hashim
Keyword(s):  
Cognitive Impairment ◽  
Nursing Homes ◽  
Construct Validity ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Geriatric Depression ◽  
Validity And Reliability ◽  
Cronbach’S Alpha ◽  
Factor Loadings ◽  
Cronbach's Alpha

Background: Geriatric Depression Scale (GDS) has been widely used in assessing depression in elderly population. Using the Ministry of Health Malaysia definition for elderly, this study aimed to examine the construct validity and reliability of the GDS (Malay version) in elderly with cognitive impairment in Malaysia. Methods: A cross-sectional validation study involving 219 elderlies with cognitive impairment was conducted using universal sampling method. Participants aged 60 years old and above, scored less than 11 for the short mini mental state examination (SMMSE), have sufficient command of the Malay or English language, residing in the government nursing homes and attending memory clinics in government hospitals in Klang Valley were sampled. The GDS-15 English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using the exploratory factor analysis and its internal consistency was examined. Results: Mean age of participants were 72.61 ± 7.79. Majority were male (50.7%), Malay (50.2%), studied at least until primary school (71.7%) and stayed at nursing homes (50.2%). Construct validity showed significant Bartlett’s test of sphericity (Chi-square = 1,340.058, P < 0.001) and Kaiser-Meyer-Olkin (KMO) test of 0.90. Factor loadings for each item in the depression domain were satisfactory ranging from 0.42 to 0.83. Factor loadings for each item in the psychosocial activities’ domain were satisfactory ranging from 0.53 to 0.76. For the questionnaire reliability analysis, the total Cronbach’s alpha for the final model was satisfactory, with and overall Cronbach’s alpha of 0.89. Cronbach’s alpha value for the depression and psychosocial activities domain was 0.861 and 0.80, respectively. Conclusion: The GDS (Malay version) is a valid and reliable tool to screen for depression in elderly with cognitive impairment.

The depression status of empty nesters in eastern rural China

2019 ◽  
Vol 47 (2) ◽  
pp. 1-9
Author(s):  
Jingjing Zhou ◽  
Linlin Xiao ◽  
Yicheng Zhou ◽  
Guoqiang Rui ◽  
Xianlin Ni
Keyword(s):  
Rural China ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Psychological Status ◽  
Geriatric Depression ◽  
Factors Affecting ◽  
Level Of Education ◽  
Depression Status ◽  
The Government

We used the Geriatric Depression Scale to investigate the depression status of empty nesters living in eastern rural China (N = 967). The results showed that more than half of the participants suffered relatively severe depression and that their mental health was not favorable. Gender, age, level of education, and marital status had a significant influence on depression status. The degree of depression of men was lower than that of women. As participants’ age increased, the degree of depression first rose until the age of 84 and then fell thereafter. The depression of unmarried empty nesters was relatively severe compared to that of married ones. Finally, a higher level of education corresponded with a lower degree of depression. There are varied factors affecting the psychological status of empty nesters in China. To improve their mental state, the government, society, and family need to collaborate and take comprehensive measures.

scholarly journals Screening for depressive symptoms in older adults in the Family Health Strategy, Porto Alegre, Brazil

2014 ◽  
Vol 48 (3) ◽  
pp. 368-377 ◽  
Author(s):  
Eduardo Lopes Nogueira ◽  
Leonardo Librelotto Rubin ◽  
Sara de Souza Giacobbo ◽  
Irenio Gomes ◽  
Alfredo Cataldo Neto
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Family Health ◽  
Severe Depression ◽  
Female Gender ◽  
Geriatric Depression ◽  
Self Rated Health ◽  
Prevalence Of Depression

OBJECTIVE To analyze the prevalence of depression in older adults and associated factors. METHODS Cross-sectional study using a stratified random sample of 621 individuals aged ≥ 60 from 27 family health teams in Porto Alegre, RS, Southern Brazil, between 2010 and 2012. Community health agents measured depression using the 15-item Geriatric Depression Scale. Scores of ≥ 6 were considered as depression and between 11 and 15 as severe depression. Poisson regression was used to search for independent associations of sociodemographic and self-perceived health with both depression and its severity. RESULTS The prevalence of depression was 30.6% and was significantly higher in women (35.9% women versus 20.9% men, p < 0.001). The variables independently associated with depression were: female gender (PR = 1.4, 95%CI 1.1;1.8); low education, especially illiteracy (PR = 1.8, 95%CI 1.2;2 6); regular self-rated health (OR = 2.2, 95%CI 1.6;3.0); and poor/very poor self-rated health (PR = 4.0, 95%CI 2.9;5.5). Except for education, the strength of association of these factors increases significantly in severe depression. CONCLUSIONS A high prevalence of depression was observed in the evaluations conducted by community health agents, professionals who are not highly specialized. The findings identified using the 15-item Geriatric Depression Scale in this way are similar to those in the literature, with depression more associated with low education, female gender and worse self-rated health. From a primary health care strategic point of view, the findings become still more relevant, indicating that community health agents could play an important role in identifying depression in older adults.

scholarly journals The geriatric depression scale in palliative care

2008 ◽  
Vol 6 (3) ◽  
pp. 213-223 ◽  
Author(s):  
Gregory B. Crawford ◽  
Julie A. Robinson
Keyword(s):  
Palliative Care ◽  
Psychometric Properties ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Severe Depression ◽  
Symptom Assessment ◽  
Assessment System ◽  
Geriatric Depression ◽  
Short Forms ◽  
Full Form

ABSTRACTObjective:This research examined the psychometric properties of previously published short forms of the Geriatric Depression Scale (GDS) in patients receiving palliative care. It also uses the full form of the GDS to examine the prevalence of nonsomatic symptoms of depression in palliative patients.Method:Participants were 84 patients with advanced cancer attending palliative care outpatient clinics. Scores for short forms of the GDS were derived from administering the original 30-item scale. Patients also completed the single item numerical analogue scale for depression from the Edmonton Symptom Assessment System and parallel numerical analogue scales for will-to-live and hope. A subset of the sample completed the measures twice. Short forms were judged on the extent to which they captured information gained from the full scale and their internal consistency, test–retest reliability, convergent and concurrent validity, and their distribution of scores.Results:Overall, five short forms showed good psychometric properties at both visits. Two of these forms were very brief. Some nonsomatic symptoms assessed on the full GDS were reported with high frequency. However, few individuals reported a large number of symptoms. At both visits, patients identified as likely to have severe depression gave different responses from other patients on most items on the GDS-30.Significance of results:Several short forms of the GDS may be appropriate for use in palliative care. Patients identified as likely to have severe depression showed many of the same symptoms that characterise depression in other geriatric populations.

scholarly journals A cross sectional study on screening for depression among elderly in rural areas of Puducherry, India

2018 ◽  
Vol 7 (1) ◽  
pp. 46
Author(s):  
Pamagal Kavithai ◽  
Anandaraj R. ◽  
Buvaneswary S. ◽  
Prakash M.
Keyword(s):  
Cognitive Impairment ◽  
Sleep Problems ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Geriatric Depression ◽  
Sectional Study ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Study Setting

Background: Depression among elderly has been a neglected health issue. Various factors hinder its early diagnosis. The objectives of this study are to screen for depression among elderly using geriatric depression scale-15 and to determine its influencing factors.Methods: A community based cross sectional study on geriatric depression was done in villages catered by a primary health centre in Puducherry. Permanent residents of the study setting, aged ≥60 years consenting for the study were included. Line listing of elderly individuals in the study setting was done and subjects were selected by simple random sampling. A pretested structured questionnaire was used to collect socio-demographic and clinic-psychological variables. Hindi mental state examination scale was used to screen for cognitive impairment (score <23). Geriatric Depression Scale (GDS-15) was used to screen for depression (score >5) among geriatric individuals. Appropriate statistical tests of significance were done.Results: Among the 360 elderly individuals screened using GDS-15 tool, 41.4% of them were found to be at a higher risk of developing depression. Significant factors for risk of depression in univariate analysis include being female, illiterate, unemployed, widow/single, having sleep problems, dependency in activities of daily living and cognitive impairment. Predictors for risk of depression evident by multivariate analysis include presence of unemployment, sleep problems and cognitive impairment.Conclusions: A higher proportion of elderly was observed to be at risk of depression.  Primary care physicians may consider screening for depression in elderly with identified risk factors and act accordingly.

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