Depression is common in late life, affecting nearly 5 million of the 31 million Americans age 65 and older. Both major and minor depression are reported in 13% of community-dwelling older adults, 24% of older medical outpatients, and 43% of both acute care and nursing home-dwelling older adults. Contrary to popular belief, depression is not a natural pan of aging. Depression is often reversible with prompt and appropriate treatment. However, if left untreated, depression may result in the onset of physical, cognitive, and social impairment as well as delayed recovery from medical illness and surgery, increased health care use, and suicide.
While there are many instruments available to measure depression, the Geriatric Depression Scale (GDS), first created by Yesavage et al. (1983), has been tested and used extensively with the older population. It is a brief questionnaire in which participants are asked to respond to the 30 questions by answering yes or no in reference to how they felt on the day of administration. Scores of O to 10 are considered normal, 11 to 20 indicate mild depression, and 21 to 30 indicate severe depression.
The GDS may be used with healthy, medically ill, and mildly to moderately cognitively impaired older adults. It has been used extensively in community, acute, and long-term care settings.
The GDS was found to have a 92% sensitivity and an 89% specificity when evaluated against diagnostic criteria. The validity and reliability of the tool have been supported through both clinical practice and research.
STRENGTHS AND LIMITATIONS
The GDS is not a substitute for a diagnostic interview by mental health professionals. It is a useful screening tool in the clinical setting to facilitate assessment of depression in older adults, especially when baseline measurements are compared to subsequent scores.
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Koenig, H.G., Meador, K.G., Cohen, J.J., & Blazer D.G. (1988). Self-rated depression scales and screening for major depression in the older Kospitalized patient with medical illness. Journal of the American Geriatrics Society, 36, 699-706.
Kurlowicz, L.H., Si NICHE Faculty. (1997). Nursing stand or practice protocol: Depression in elderly patients. Geriatric Nursing, IS, 192-199.
NIH Consensus Development Panel. (1992). Diagnosis and treatment of depression in late life. Journal of the American Medical Association, 268, 1018-1024.
Sheikh, R.L., 8t Yesavage, J.A. (1986). Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. Clinical Gerontologi:!, 5, 165-173.
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V, Adey, M., & Leirer, V.O. (1983). Development and validation of a geriatric depression screening scale; A preliminary report. Journal of Psychiatric Research, 17, 37-49.
The following tool represents an effective quantitative method to gather information on depression in older adults. We invite nurses to duplicate the tool and encourage staff to carry it for reference.
GERIATRIC DEPRESSION SCALE*