A PROSPECTIVE EVALUATION OF THE GERIATRIC DEPRESSION SCALE IN AN OUTPATIENT GERIATRIC ASSESSMENT-CENTER

Objective: To prospectively evaluate the Geriatric Depression Scale (GDS) in cognitively intact and impaired patients undergoing outpatient geriatric assessment. Subjects: One hundred ninety-four geriatric patients evaluated in a 1-year period. Setting: The outpatient Geriatric Assessment Center of the University of Nebraska Medical Center. Measurements: The 30-item GDS was completed by all patients. The patients were then evaluated by one of three geriatric psychiatrists who were blind to the GDS results. The prospective clinical diagnosis of major depression was compared to the GDS results. Patients were categorized as cognitively impaired or intact on the basis of the Mini-Mental State Examination. Data were analyzed using ROC curves. An optimal cutoff was identified which was the total score on the GDS with the highest combined sensitivity and specificity. Results: ROC curve analyses showed good agreement between the clinical diagnosis and the GDS in both cognitively intact and impaired subjects. Cognitively intact, euthymic patients reported a mean of 8.4 symptoms, while cognitively impaired, euthymic patients, reported a mean of 8.7. Cognitively intact, depressed patients reported a mean of 14.7 symptoms, while cognitively impaired, depressed patients reported a mean of 15.0. Conclusions: This study provides further evidence that the GDS is as accurate a screening test for depression in cognitively impaired as in intact patients.