Comparison Study of the Different Abbreviated Versions of the Geriatric Depression Scale

NCT ID: NCT04180683

Last Updated: 2020-12-01

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

331 participants

Study Classification

OBSERVATIONAL

Study Start Date

2020-03-01

Study Completion Date

2020-11-30

Brief Summary

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This multicenter study conducted in several Portuguese institutions aims to compare the screening ability of the several Geriatric Depression Scale (GDS) validated versions for the Portuguese population (GDS-30, GDS-15, GDS-10 and GDS-5), as well as to establish their psychometric properties, using a large sample of elderly people with neurocognitive disorders attending social responses addressed to the elderly. Secondarily, cognitive state will be assessed.

Detailed Description

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Depression is the most common mental health problem among older people, both in Portugal and around the world. Due to the fast aging of the world population, depression is a significant problem, with an estimated prevalence between 8% and 16%, which is more common in institutionalized elderly. Several studies have shown the negative consequences of depression in the elderly, which has been associated with higher morbidity and mortality rates, increased use of health services and increased costs. In addition, older people's depression is associated with major disability, chronic health problems, higher suicide rates, dementia and a lower quality of life. However, it is often an unrecognized, and therefore untreated, problem.

Under these circumstances, screening people at risk of depression (people with chronic illness, stroke, dementia, institutionalized or attending social responses, etc.) is a strategy with potential to reduce the impact of depression among the elderly.

One of the most commonly used screening scales for depressive symptoms in elderly is the Geriatric Depression Scale (GDS), a widely known and widely used scale designed specifically for older people. For this reason, it does not include questions related to somatic symptoms, as they lack discriminatory value in older people, because they can be attributed to other physical conditions or the aging process. The original version of the scale is composed by 30 items with a dichotomous response (yes/no) assessing motivation, energy, past and future orientation, mood, cognitive complaints, anxiety and irritability. The GDS scale has good psychometric properties and has been evaluated in a wide range of geriatric populations, institutionalized patients, elderly with chronic health problems, people with dementia, etc. In order to achieve better time efficiency in its administration, the original 30-item scale was abbreviated to a 15-item version. Posteriorly, multiple shorter versions of this scale were developed, composed by one, four, five, ten or twelve items.

The GDS scale has been widely translated and validated worldwide. In Portugal, the GDS-30 was adapted and validated by Pocinho, Farate, Dias, Lee and Yesavage. The versions of GDS-15, GDS-10 and GDS-5 were adapted and validated by Apóstolo and colleagues having demonstrated good psychometric properties and, therefore, potential as a screening tool for depressive symptoms in older people.

The aim of this study is to compare the screening ability of the several validated versions for the Portuguese population of the GDS scale (GDS-30, GDS-15, GDS-10 and GDS-5), as well as to establish their psychometric properties, using a large sample of elderly patients attending social responses addressed to the elderly. This study will allow recommendations on which is the most sensitive GDS version for detecting depressive symptoms by comparing them with other depression screening scales.

To achieve this, the results of the several GDS versions will be compared with the application of a gold standard, the Beck-II Depression Inventory \[BDI-II\].

Regarding the BDI-II, it is important to mention its good psychometric characteristics when used in the elderly population, which were evident in studies that compared the psychometric characteristics of different scales used to assess depression in the elderly. I was concluded that this instrument obtained a test-retest value of 0.93, Cronbach's α ranged from 0.76 to 0.91 in elderly Americans, in a community-dwelling elderly, in Puerto Rican residents, in elderly with heart problems, and in women living in institutions for the elderly. In elderly clinical samples, Cronbach's α ranged from 0.89 to 0.92. BDI is significantly and positively correlated with CES-D (r = 0.69, p \<0.001) and with GDS (r = 0.71, p \<0.001). The clinical utility of BDI-II is proven and high because of its clinical sensitivity and consistency with the DSM-IV criteria. In addition, it identifies many depressive symptoms and is one of the most commonly used instruments in the elderly without cognitive decline and also in non-clinical samples, as it is brief and easily administered and scored.

On the other hand, in another study where BDI-II was applied to elderly people with cognitive deficits, it was found that this population has symptoms similar to those of young people and adults, supporting the validity of this instrument in this population.

In order to reinforce the assessment of the screening ability of the several GDS versions validated for the Portuguese population, as well as to establish their psychometric properties, a sample (estimated at about 25%) will be defined, in which the GDS will be compared with a gold standard, that will consist of a semi-structured interview guide based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) for depressive disorders. For this sample, a questionnaire will be answered by the professionals who perform the evaluation, regarding their opinion about which GDS version is more easily understandable by the participants and the participants' preference regarding the different versions of GDS, as a means of assessing which version is more discernible for the participants. All the GDS versions validated for the Portuguese population (GDS-30, GDS-15, GDS-10 and GDS-5) will be administered to these participants.

Conditions

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Depression Depressive Disorder Neurocognitive Disorders Dementia

Keywords

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Depression Depressive Disorder Neurocognitive Disorders Dementia Elderly Geriatric Depression Scale Beck Depression Inventory - II

Study Design

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Observational Model Type

OTHER

Study Time Perspective

CROSS_SECTIONAL

Study Groups

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Semi-structured interview group

Participants assigned to this group will be administered the GDS-30, GDS-15, GDS-10 nad GDS-5, and also the BDI-II and a semi-structured interview based on the DSM-5 criteria. The psychologists performing the assessment will answer a questionnaire about which GDS version was more easily understandable by the participants and the participants' preference regarding the GDS versions.

Battery of screening tests with semi-structured interview

Intervention Type OTHER

First, participants will be administered the Mini-Mental State Examination to assess if they meet the inclusion criteria and an ID will be assigned to the participants that meet the criteria. Posteriorly, a clinical psychologist will administer the GDS-30, GDS-15, GDS-10 and GDS-5, the BDI-II and a semi-structured interview about depressive disorders according to the DSM-5 criteria. Participants with even ID's from each institution will be answer the instruments according to the order GDS-30, GDS-10, BDI-II, GDS-5 e GDS-15 and participants with odd ID's will answer the battery in the reverse order. The assessment session will take place in a single moment in time. After the assessment, the clinical psychologist will answer a questionnaire about which version was more easily understandable by the participants and the participants' preference regarding the GDS versions.

No semi-structured interview group

Participants assigned to this group will be administered the GDS-30 and the GDS-15, and also the BDI-II.

Battery of screening tests without semi-structured interview

Intervention Type OTHER

First, participants will be administered the Mini-Mental State Examination to assess if they meet the inclusion criteria an ID will be assigned to the participants that meet the criteria. Posteriorly, a psychologist will administer the GDS-30, GDS-15 and the BDI-II. Participants with even ID's from each institution will answer the instruments according to the order GDS-30, BDI-II and GDS-15 and participants with odd ID's the administration order will answer the battery in the reverse order. The assessment session will take place in a single moment in time.

Interventions

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Battery of screening tests with semi-structured interview

First, participants will be administered the Mini-Mental State Examination to assess if they meet the inclusion criteria and an ID will be assigned to the participants that meet the criteria. Posteriorly, a clinical psychologist will administer the GDS-30, GDS-15, GDS-10 and GDS-5, the BDI-II and a semi-structured interview about depressive disorders according to the DSM-5 criteria. Participants with even ID's from each institution will be answer the instruments according to the order GDS-30, GDS-10, BDI-II, GDS-5 e GDS-15 and participants with odd ID's will answer the battery in the reverse order. The assessment session will take place in a single moment in time. After the assessment, the clinical psychologist will answer a questionnaire about which version was more easily understandable by the participants and the participants' preference regarding the GDS versions.

Intervention Type OTHER

Battery of screening tests without semi-structured interview

First, participants will be administered the Mini-Mental State Examination to assess if they meet the inclusion criteria an ID will be assigned to the participants that meet the criteria. Posteriorly, a psychologist will administer the GDS-30, GDS-15 and the BDI-II. Participants with even ID's from each institution will answer the instruments according to the order GDS-30, BDI-II and GDS-15 and participants with odd ID's the administration order will answer the battery in the reverse order. The assessment session will take place in a single moment in time.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Having a diagnosis of neurocognitive disorder according to the DSM-5 criteria and based on the MMSE scores.
* To be able to understand and answer the instruments' questions.
* Being 65 years of age or older.
* Being a native Portuguese speaker.
* To attend a social response addressed to the elderly in an institution.

Exclusion Criteria

* Having severe sensory and physical limitations, severe disconnection from the environment, or presence of severe neuropsychiatric symptoms that make it impossible to administer the assessment battery.
Minimum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Rsocialform - Geriatria, Lda

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Susana I Justo Henriques, PhD

Role: PRINCIPAL_INVESTIGATOR

Cediara and Nursing School of Coimbra

Enrique Pérez Saéz, PhD

Role: PRINCIPAL_INVESTIGATOR

CRE Alzheimer and University of Salamanca

João L Alves Apóstolo, PhD

Role: PRINCIPAL_INVESTIGATOR

Nursing School of Coimbra

Patrícia Otero Otero, PhD

Role: PRINCIPAL_INVESTIGATOR

Universidade da Coruña

Fernando L Vázquez González, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Santiago de Compostela

Locations

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Cediara - Associação de Solidariedade Social de Ribeira de Fráguas

Albergaria-a-Velha, Aveiro District, Portugal

Site Status

Rsocialform - Geriatria, Lda.

Mealhada, Aveiro District, Portugal

Site Status

Centro de Assistência Paroquial da Pampilhosa

Mealhada, Aveiro District, Portugal

Site Status

Fundação Luiz Bernardo de Almeida

Vale de Cambra, Aveiro District, Portugal

Site Status

Lar D. Pedro V

Praia da Vitória, Azores, Portugal

Site Status

Santa Casa da Misericórdia de Ferreira do Alentejo

Ferreira do Alentejo, Beja District, Portugal

Site Status

Centro Social e Paroquial de S. Martinho de Medelo

Fafe, Braga District, Portugal

Site Status

Centro Social Vale do Homem

Vila Verde, Braga District, Portugal

Site Status

Lar de S. José

Covilha, Castelo Branco District, Portugal

Site Status

Santa Casa da Misericórdia do Fundão

Fundão, Castelo Branco District, Portugal

Site Status

PRODECO - Progresso e Desenvolvimento de Covões

Cantanhede, Coimbra District, Portugal

Site Status

Fundação Sarah Beirão/António Costa Carvalho

Tábua, Coimbra District, Portugal

Site Status

Santa Casa da Misericórdia de Alcobaça

Alcobaça, Leiria District, Portugal

Site Status

Santa Casa da Misericórdia de Alvorge

Ansião, Leiria District, Portugal

Site Status

Centro Social e Paroquial de S. Vicente de Alcabideche

Alcabideche, Lisbon District, Portugal

Site Status

Fundação AFID Diferença

Amadora, Lisbon District, Portugal

Site Status

Irmãs Hospitaleiras - Casa de Saúde da Idanha

Sintra, Lisbon District, Portugal

Site Status

Santa Casa da Misericórdia de Arronches

Arronches, Portalegre District, Portugal

Site Status

Santa Casa da Misericórdia de Arez

Nisa, Portalegre District, Portugal

Site Status

Associação de Solidariedade Social de Ponte de Sôr

Ponte de Sôr, Portalegre District, Portugal

Site Status

Quintinha da Conceição Sousa & Silva Lda

Maia, Porto District, Portugal

Site Status

Centro Social Paroquial de Recarei

Paredes, Porto District, Portugal

Site Status

Associação de Desenvolvimento da Vila de Paço Sousa

Penafiel, Porto District, Portugal

Site Status

Centro Social de Bem-Estar de Alcanena

Alcanena, Santarém District, Portugal

Site Status

Santa Casa da Misericórdia de Canha

Montijo, Setúbal District, Portugal

Site Status

Santa Casa da Misericórdia de Caminha

Caminha, Viana do Castelo District, Portugal

Site Status

Santa Casa da Misericórdia de Melgaço

Melgaço, Viana do Castelo District, Portugal

Site Status

Santa Casa da Misericórdia de Tarouca

Tarouca, Viseu District, Portugal

Site Status

Santa Casa da Misericórdia de Vouzela

Vouzela, Viseu District, Portugal

Site Status

Santa Casa da Misericórdia de Castelo Branco

Castelo Branco, , Portugal

Site Status

Cáritas de Coimbra

Coimbra, , Portugal

Site Status

Fundação João Bento Raimundo

Guarda, , Portugal

Site Status

Countries

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Portugal

References

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Other Identifiers

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20112019

Identifier Type: -

Identifier Source: org_study_id