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

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 DanieleDavide Seripa, Vincenzo Solfrizzi, Antonello Bellomo, Alberto Bellomo, Giancarlo Logroscino, Giandomenico Logroscino, Francesco Panza

Research output: Contribution to journalArticle

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.
Original languageEnglish
Pages (from-to)N/A-N/A
JournalPsychiatry Research
Volume308
DOIs
Publication statusPublished - 2022

Keywords

  • Apathy
  • Biomarkers
  • Dementia
  • Depression
  • Mild cognitive impairment

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