The diagnostic accuracy of late-life depression is influenced by subjective memory complaints and educational level in an older population in Southern Italy

Psychiatry research

Psychiatry Res. 2021 Dec 18;308:114346. doi: 10.1016/j.psychres.2021.114346. Online ahead of print.

ABSTRACT

The prevalence of late-life depression (LLD) depends on the study sample, measurements, and diagnostic approaches. We estimated the 30 item-Geriatric Depression Scale (GDS-30) accuracy against the gold standard LLD diagnosis made with the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders, focusing on the prevalence of a late-life major depressive disorder (MDD), in a population-based sample of 843 subjects aged>65 years, subdivided into three groups: normal cognition, subjective memory complaints, and mild cognitive impairment. At the optimal cut-off score (≥4), the GDS-30 showed 65.1% sensitivity and 68.4% specificity for LLD (63% and 66% for late-life MDD, respectively). Using the standard cut-off score (≥10), the GDS-30 specificity reached 91.2%, while sensitivity dropped to 37.7%, indicating a lower screening accuracy [area under the curve(AUC):0.728, 95% confidence interval(CI):0.67-0-78]. The GDS-30 performance was associated with educational level, but not with age, gender, cognition, apathy, and somatic/psychiatric multimorbidity. For subjective memory complaints subjects, at the optimal cut-off score (≥7), the GDS-30 showed better discrimination performances (AUC=0.792,95%CI:0.60-0.98), but again the educational level affected the diagnostic performance. In subjective memory complaints subjects, symptom-based scales like the GDS-30 may feature a better performance for diagnosing depression in older age, but the GDS-30 seems to require adjustment to the patient's educational level.

PMID:34953202 | DOI:10.1016/j.psychres.2021.114346

Authors

Madia Lozupone
Francesca D'Urso
Massimiliano Copetti
Rodolfo Sardone
Simona Arcuti
Fabio Castellana
Ilaria Galizia
Lucia Lofano
Federica Veneziani
Carla Piccininni
Maria Rosaria Barulli
Alessandra Grasso
Petronilla Battista
Rosanna Tortelli
Rosa Capozzo
Chiara Griseta
Fabrizio Doricchi
Nicola Quaranta
Emanuela Resta
Antonio Daniele
Davide Seripa
Vincenzo Solfrizzi
Antonello Bellomo
Giancarlo Logroscino
Francesco Panza