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Usefulness of Beck Depression Inventory (BDI) in the Korean elderly population
- Authors:
- JO Sangmee Ahn, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.218-223.
- Publisher:
- Wiley
This study aimed to evaluate the diagnostic validity of the Beck Depression Inventory (BDI) in the elderly and to suggest an optimal cut-off score in order to screen major depressive disorder. The BDI and an elderly health questionnaire were administered to 2729 subjects over the age of 60 chosen by stratified random sampling in a Ansan City, South Korea. The BDI and geriatric depression scale (GDS) were examined at about a two-year interval. A reliability and validity test, a factor analysis and an ROC curve analysis were performed. Eighty-four subject had depression and 2645 subjects were rated as normal. The BDI showed significant positive internal consistency and test-retest reliability. Convergent validity with GDS was significantly positive, and an exploratory factor analysis revealed four factors. The authors suggest a score of 16 as the optimal cut-off point for the BDI when screening for major depression. The results of this study showed that the Korean version of the BDI is appropriate for screening for depression and 16 is the optimal cut-off score for the Korean elderly. Screening of elderly depression with BDI in the community would be valuable when comparing with younger adults and with their former BDI data which were taken when they were young.
Validation of the Spanish version of the EURO-D scale: an instrument for detecting depression in older people
- Authors:
- LARRAGA Laura, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 21(12), December 2006, pp.1199-1205.
- Publisher:
- Wiley
The objective was to standardize the EURO-D scale as a method for detecting depression in Spanish older people. In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test-retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated. A high internal consistency was obtained in both phases of the study ( = 0.75; = 0.79, respectively). Test-retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89-0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale. The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results.
Validation of the Retardation Rating Scale for detecting depression in geriatric inpatients
- Authors:
- BONIN-GUILLAUME Sylvie, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(1), January 2007, pp.69-76.
- Publisher:
- Wiley
Validation in the elderly of the Retardation Rating Scale (RRS), which includes items related to motor and mental retardation but not vegetative items, and may be particularly well-suited for the diagnosis of depression in the elderly. One hundred and sixty-five geriatric inpatients (105 depressed), aged 65 and over, without dementia, neuroleptic medication and increased risk of slowed mobility, were assessed with the RRS and three validated gold-standard scales for geriatric depression (Hamilton Depression Rating Scale, Montgomery and Asberg Depression Rating Scale, Geriatric Depression Scale). Factor analysis used varimax rotation, Cronbach's, Spearman's and Ferguson's coefficients and the Mann-Whitney U-test to evaluate construct and internal consistency. Convergent validity and Receiver Operating Characteristics curves were also analyzed. Factor analysis retained three interpretable domains: (1) motor items (45% of the variance); (2) mental items and (3) the cognitive items. Internal consistency was high ( = 0.91). Each item was strongly correlated with the total RRS score and associated with depression. The RRS showed good convergent validity and its total score increased with depression severity. A cut-off score of 10 yielded 79% sensitivity and 80% specificity, with 80% of the patients properly classified, that is 15% more than standard observer scales. RRS is a valid screening tool for depression and improves recognition of depression in geriatric inpatients.
The psychometric properties of the Multi-Dimensional Observation Scale for Elderly Subjects (MOSES) in middle aged and older populations of people with mental retardation
- Authors:
- STURMEY P., TSIOURI J. A.,S, PATTI P.
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(2), February 2003, pp.131-134.
- Publisher:
- Wiley
This article seeks to assess the internal consistency, inter-scale correlations and factor structure of the MOSES with older adults with mental retardation. A series of outpatients with learning difficulties were assessed with the MOSES. 163 middle aged and older adults with learning difficulties living in community settings participated. MOSES appears to be a psychometrically adequate instrument to screen older adults
The mini-mental state examination (MMSE) in an elderly immigrant Gujarati population in the United Kingdom
- Authors:
- LINDESAY James, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(12), December 1997, pp.1155-1167.
- Publisher:
- Wiley
Evaluates the performance of a Gujarati version of the MMSE as a screening instrument for dementia. The effect of ethnicity on MMSE performance is also examined. Finds this Gujarati version of the MMSE performed adequately as a screen for dementia in this immigrant community population. Concludes that further evaluation of its performance is required in larger community samples, clinical samples and in native Indian Gujaratis.
Screening for alcohol misuse in older people
- Authors:
- LUTTRELL Steven, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(12), December 1997, pp.1151-1154.
- Publisher:
- Wiley
Evaluates whether the CAGE, MAST-G or an abnormally high MCV are effective screening instruments for alcohol misuse. The results confirm previous UK studies which indicate that the CAGE and an abnormally high MCV are poor screening instruments for alcohol misuse in older patients and also indicate that the MAST-G is an insensitive screening instrument. A new two-step instrument with five questions in total was generated, which requires further validation.
Diagnostic accuracy of Instrumental Activities of Daily Living for dementia in community-dwelling older adults
- Authors:
- MAO Hui-Fen, et al
- Journal article citation:
- Age and Ageing, 47(4), 2018, p.551–557.
- Publisher:
- Oxford University Press
Background: many people living with dementia remain underdiagnosed and unrecognised. Screening strategies are important for early detection. Objective: to examine whether the Lawton’s Instrumental Activities of Daily Living (IADL) scale, compared with other cognitive screening tools—the Mini-Mental State Examination (MMSE), and the Ascertain Dementia 8-item Informant Questionnaire (AD8)—can identify older (≥ 65 years) adults with dementia. Design: population-based cross-sectional observational study. Setting: all 19 counties in Taiwan. Participants: community-dwelling older adults (n = 10,340; mean age 74.87 ± 6.03). Methods: all participants underwent a structured in-person interview. Dementia was identified using National Institute on Aging-Alzheimer’s Association core clinical criteria for all-cause dementia. Receiver operator characteristic curves were used to determine the discriminant abilities of the IADL scale, MMSE and AD8 to differentiate participants with and without dementia. Results: 917 (8.9%) participants with dementia were identified, and 9,423 (91.1%) participants without. The discriminant abilities of the MMSE, AD8 and IADL scale (cutoff score: 6/7; area under curve = 0.925; sensitivity = 89%; specificity = 81%; positive likelihood ratio = 4.75; accuracy = 0.82) were comparable. Combining IADL with AD8 scores significantly improved overall accuracy: specificity = 93%; positive likelihood ratio = 11.74; accuracy = 0.92. Conclusions: the findings support using IADL scale to screen older community-dwelling residents for dementia: it has discriminant power comparable to that of the AD8 and MMSE. Combining the IADL and the AD8 improves specificity. (Edited publisher abstract)
Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians
- Authors:
- ANKRI Joel, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(3), March 2005, pp.254-260.
- Publisher:
- Wiley
The purpose of this study was to explore the structure of the Zarit Burden Interview (ZBI) for informal caregivers of patients suffering from AD or related disorders, and to examine the relations of the dimensions found with functional disabilities and other patient health indicators. Caregiver burden was measured by the 22-item ZBI. Caregivers' and care recipients' characteristics were collected with the MDS (Minimum Data Set) of the RAI (Resident Assessment Instrument) Home Care instrument. Data on dementia (diagnosis, severity, MMSE) were also obtained. Burden data were analysed by principal component analysis (PCA) with varimax rotation. Relationships between scores on PCA factors and care recipients' health indicators were studied with inferential statistical tests. Three dimensions of burden were found: effect on the social and personal life of caregivers, psychological burden and feelings of guilt. Some health variables were linked to these dimensions. Spouses and children perceived burden differently. Spouse caregivers emphasized the deterioration of their personal and social life. Children, less involved in daily care, were more prone to feel guilt that they were not doing enough for their parent.
GP concordance with advice for treatment following a multidisciplinary psychogeriatric assessment
- Authors:
- WOLFS Claire A. G., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(3), March 2007, pp.233-240.
- Publisher:
- Wiley
The aim was to evaluate the concordance of General Practitioners (GPs) with advice for treatment after a multidisciplinary psychogeriatric assessment by the Diagnostic Observation Centre for PsychoGeriatric patients (DOC-PG). Concordance checklists, listing the recommendations from the multidisciplinary team, were sent to the GPs in order to establish GP concordance. Regression models were used to study the associations between various patient and GP characteristics and level of concordance. Furthermore, results of a questionnaire (to identify the level of satisfaction regarding the services provided by the DOC-PG) were compared with the level of GP concordance. Based on 530 recommendations, the overall GP concordance rate amounted to 71%. The most common types of advice pertained to medication, GP follow-up/advice and referral. GP concordance with advice regarding admissions was the highest, followed by advice concerning the arrangement of daycare, home care and the adaptation of medication. GP concordance was lowest for referral recommendations to other specialties and recommendations regarding psychoeducation. Concordance was higher for patients who lived alone, for patients with fewer cognitive problems, when the number of recommendations did not exceed six and in group practices. Concordance was dependent on the type of advice. Satisfaction with DOC-PG did not correlate with the level of concordance. In general, GPs showed a high level of concordance with advice from the DOC-PG. Enhancement of GP concordance can be achieved by limiting the number of recommendations, giving detailed explanations about the purpose of recommendations and educating GPs by doing.
The Middelheim Frontality Score: a behavioural assessment scale that discriminates frontotemporal dementia from Alzheimer's disease
- Author:
- DE DEYN Peter Paul
- Journal article citation:
- International Journal of Geriatric Psychiatry, 20(1), January 2005, pp.70-79.
- Publisher:
- Wiley
Despite striking neuropsychological and behavioural differences between Alzheimer's disease (AD) and frontotemporal dementia (FTD), clinical diagnostic criteria failed to discriminate FTD from AD patients. We therefore developed the Middelheim Frontality Score (MFS), a disease-long clinical and behavioural assessment tool that measures frontal lobe features, and set up this prospective study in clinically diagnosed AD and FTD patients to assess discriminatory power and intra- and inter-rater variability. Patients with probable AD (n = 400) and FTD (n = 62) were included. The MFS was obtained by summating the scores obtained in a standardized fashion on ten items yielding a total maximal score of 10. Information was obtained through an interview of the patient and her/his caregiver, clinical files and behavioural observation. Comparing mean total MFS scores, FTD patients (6.3 ± 1.8) had significantly higher scores than AD patients (3.1 ± 1.8) (p < 0.001). Distribution of scores on individual MFS items was significantly different between both disease groups (2 = 76.2; p < 0.001). A moderately positive and highly significant correlation was shown between the total MFS score and diagnosis FTD (r = 0.478; p < 0.0001). Applying a total MFS score of 5 as discriminatory cut-off, a specificity of 89.0% and a sensitivity of 88.7% were achieved. Intra- and inter-rater variability was calculated in a different study population by means of retest correlation, revealing moderate to strong positive correlations of high statistical significance. The MFS is a clinical and behavioural assessment scale that measures frontal lobe features and that was shown to reliably discriminate FTD from AD patients.