Development of a shorter version of the geriatric depression scale for visually impaired older patients

Objective: To validate a shorter version of the Geriatric Depression Scale (GDS) for older, visually impaired patients. Participants: Subjects were 70 visually impaired adults over age 65 who were presenting for services at a low vision clinic. Method: Subjects were interviewed by a geriatric nurse practitioner. A structured clinical interview was used to ascertain major depression, and the 15-item GDS was used to assess depressive symptoms. A multiple logistic regression was performed in which the dependent variable was clinical diagnosis of major depression and the independent variables were the 15 GDS items. Four items were significant, and were used to form the GDS-Abbreviated (GDS-A) scale. Sensitivity and specificity analyses were performed on various combinations of these four items to generate an effective cutoff score. Results:Endorsing any two or more of the following four items-(a) dissatisfied with life, (b) feeling helpless, (c) reporting problems with memory, and (d) lost activities and interests-yielded the best results with a sensitivity of .71 and a specificity of .88. This GDS-A cutoff score better differentiates depressed from nondepressed individuals than the cutoff score of 5 that is recommended for the GDS-15. Conclusion: The GDS-A's short format and strong discriminating ability make it an effective, convenient tool for screening visually impaired, older patients for depression.