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Nephron Clin Pract. 2011;118(2):c72-7. doi: 10.1159/000320037. Epub 2010 Dec 8.

Screening for depression in elderly hemodialysis patients.

Author information

1
Division of Nephrology, Department of Medicine, University of Virginia Health System, Charlottesville, VA 22908, USA. rb8mh@virginia.edu

Abstract

BACKGROUND:

Depression is common and associated with increased morbidity and mortality in elderly (≥65 years) hemodialysis patients. Beck's Depression Inventory (BDI) and the Geriatric Depression Scale (GDS) have been used in different cohorts to screen for depression.

OBJECTIVES:

We aimed to evaluate the 15-item GDS (GDS-15) as such a tool in elderly hemodialysis patients and compare it with BDI, a previously validated tool in younger hemodialysis patients.

DESIGN:

Cross-sectional study.

SETTING:

Four out-patient hemodialysis units; 1 based in a university hospital and 3 based in the community.

PARTICIPANTS:

Hemodialysis patients aged 65 years and older.

INTERVENTION:

Both tools were administered to all participants, and a geriatric psychiatrist blinded to the results evaluated them for depression by the gold standard psychiatric interview.

MEASUREMENTS:

The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for both tools were assessed against the psychiatric interview (n = 62).

RESULTS:

Patients who were depressed according to the psychiatric interview had significantly higher GDS-15 and BDI scores compared to those not depressed (p < 0.01 both). ROC curves showed high predictive accuracy of the GDS-15 and BDI (area under the curve: 0.808 and 0.729) versus the psychiatric interview. The GDS-15 cutoff with the best diagnostic accuracy was 5 with a sensitivity of 63%, specificity of 82%, PPV of 60% and NPV of 83%. The BDI cutoff with the best diagnostic accuracy was 10 with a sensitivity of 68%, specificity of 77%, PPV of 57% and NPV of 85%.

CONCLUSION:

These results provide evidence that the GDS-15 shows validity in comparison to a gold standard and can be used to screen for depression in the elderly hemodialysis population.

PMID:
21150214
DOI:
10.1159/000320037
[Indexed for MEDLINE]

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