Risk for Suicide Among the Elderly: Is the Geriatric Depression Scale a Useful Screening Tool?

Abstract

Introduction

Depression is among the main risk factors for suicide. The Geriatric Depressions Scale (GDS-30, GDS-15) is depression screening instrument specifically developed for the elderly.

Objectives and aims

To provide a systematic review of the screening accuracy of both GDS versions.

Methods

An electronic search was performed using Medline, Embase, Cinahl, Psyndex and Cochrane library. The selection and examination of papers was done by two reviewers independently. The following studies were excluded: number of depression cases less than 10, no clear case criterion, phone version, psychiatric samples.

Results

Of 173 papers which were read and examined, only 42 papers were included. For both GDS versions similar mean validity indices were found (GDS-30: sensitivity 0.753, specificity 0.770; GDS-15: sensitivity 0.805, specificity 0.750). Using pooled samples we could not find significant differences between the two versions of the GDS. Using comparative studies based on identical samples, both GDS versions showed significantly better validity indices than the “Yale-1-question” screen, but did not differ from the CES-D. Frequently, essential information about research methods was not given. When methods were reported, the differing methods (e.g. concerning blinding, cut-off values, sampling procedures) limit the comparability of primary studies.

Conclusions

In general, the GDS seems to be sufficient for depression screening. While early recognition of depression is essential for identifying persons at risk for suicide, the GDS does not explicitly focus on this problem.