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Measurement and Assessment in Late-Life Depression

  • Chapter
Prevention of Late-Life Depression

Part of the book series: Aging Medicine ((AGME,volume 9))

Abstract

This chapter addresses the measurement and assessment of depression among older adults, with a view toward its importance in developing optimal depression prevention strategies. Overview is provided regarding commonly used dimensional and categorical measures of depression. Specific examples of depressive symptom scales as well as structured and semi-structured diagnostic interviews are described in detail. Special attention is placed on relative advantages and limitations of each measure or assessment method. Evidence for the reliability and validity of instruments for the measurement of depressive symptoms specifically among older adults is discussed in detail and illustrated in accompanying tables.

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References

  1. Radloff LS. The CES-D scale: a self report depression scale for research in the general population. Appl Psychol Meas. 1977;1:385–401.

    Article  Google Scholar 

  2. Dozeman E, van Schaik DJ, van Marwijk HW, Stek ML, van der Horst HE, Beekman AT. The center for epidemiological studies depression scale (CES-D) is an adequate screening instrument for depressive and anxiety disorders in a very old population living in residential homes. Int J Geriatr Psychiatry. 2011;26(3):239–46.

    Article  PubMed  Google Scholar 

  3. Andresen EM, Malmgren JA, Carter WB, Patrick DL. Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). Am J Prev Med. 1994;10(2):77–84.

    CAS  PubMed  Google Scholar 

  4. Irwin M, Artin KH, Oxman MN. Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med. 1999;159(15):1701–4.

    Article  CAS  PubMed  Google Scholar 

  5. Ros L, Latorre JM, Aguilar MJ, Serrano JP, Navarro B, Ricarte JJ. Factor structure and psychometric properties of the center for epidemiologic studies depression scale (CES-D) in older populations with and without cognitive impairment. Int J Aging Hum Dev. 2011;72(2):83–110.

    Article  CAS  PubMed  Google Scholar 

  6. Blank K, Gruman C, Robison JT. Case-finding for depression in elderly people: balancing ease of administration with validity in varied treatment settings. J Gerontol A Biol Sci Med Sci. 2004;59(4):378–84.

    Article  PubMed  Google Scholar 

  7. Lyness JM, Noel TK, Cox C, King DA, Conwell Y, Caine ED. Screening for depression in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale and the Geriatric Depression Scale. Arch Intern Med. 1997;157(4):449–54.

    Article  CAS  PubMed  Google Scholar 

  8. Beekman AT, Geerlings SW, Deeg DJ, Smit JH, Schoevers RS, de Beurs E, Braam AW, Penninx BW, van Tilburg W. The natural history of late-life depression: a 6-year prospective study in the community. Arch Gen Psychiatry. 2002;59(7):605–11.

    Article  PubMed  Google Scholar 

  9. Haringsma R, Engels GI, Beekman AT, Spinhoven P. The criterion validity of the Center for Epidemiological Studies Depression Scale (CES-D) in a sample of self-referred elders with depressive symptomatology. Int J Geriatr Psychiatry. 2004;19(6):558–63.

    Article  CAS  PubMed  Google Scholar 

  10. Powers JR, Young AF, Russell A, Pachana NA. Implications of non-response of older women to a short form of the Center for Epidemiologic Studies Depression Scale. Int J Aging Hum Dev. 2003;57(1):37–54.

    Article  PubMed  Google Scholar 

  11. Cole SR, Kawachi I, Maller SJ, Berkman LF. Test of item-response bias in the CES-D scale. experience from the New Haven EPESE study. J Clin Epidemiol. 2000;53(3):285–9.

    Article  CAS  PubMed  Google Scholar 

  12. Yang FM, Jones RN. Center for Epidemiologic Studies-Depression Scale (CES-D) item response bias found with Mantel-Haenszel method was successfully replicated using latent variable modeling. J Clin Epidemiol. 2007;60(11):1195–200.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Gallo JJ, Rabins PV. Depression without sadness: alternative presentations of depression in late life. Am Fam Physician. 1999;60(3):820–6.

    CAS  PubMed  Google Scholar 

  14. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 4th ed. Washington, DC: APA; 1994.

    Google Scholar 

  15. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1983;17:37–49.

    Article  CAS  Google Scholar 

  16. Olin JT, Schneider LS, Eaton EM, Zemansky MF, Pollack VE. The Geriatric Depression Scale and the Beck Depression Inventory as screening instruments in an older adult outpatient population. Psychol Assess. 1992;4:190–2.

    Article  Google Scholar 

  17. Mitchell AJ, Bird V, Rizzo M, Meader N. Which version of the geriatric depression scale is most useful in medical settings and nursing homes? Diagnostic validity meta-analysis. Am J Geriatr Psychiatry. 2010;18(12):1066–77.

    Article  PubMed  Google Scholar 

  18. Gallo JJ, Bogner HR, Fulmer T. Handbook of geriatric assessment. Sudbury, MA: Jones & Bartlett Publishers; 2005.

    Google Scholar 

  19. Marc LG, Raue PJ, Bruce ML. Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. Am J Geriatr Psychiatry. 2008;16(11):914–21.

    Article  PubMed Central  PubMed  Google Scholar 

  20. Hegeman JM, Kok RM, van der Mast RC, Giltay EJ. Phenomenology of depression in older compared with younger adults: meta-analysis. Br J Psychiatry. 2012;200(4):275–81.

    Article  CAS  PubMed  Google Scholar 

  21. Sheikh J, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986;6:165–73.

    Google Scholar 

  22. Nyunt MS, Fones C, Niti M, Ng TP. Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging Ment Health. 2009;13(3):376–82.

    Article  PubMed  Google Scholar 

  23. Sullivan PF, Kessler RC, Kendler KS. Latent class analysis of lifetime depressive symptoms in the national comorbidity survey. Am J Psychiatry. 1998;155(10):1398–406.

    Article  CAS  PubMed  Google Scholar 

  24. Lamers F, de Jonge P, Nolen WA, Smit JH, Zitman FG, Beekman AT, Penninx BW. Identifying depressive subtypes in a large cohort study: results from the Netherlands Study of Depression and Anxiety (NESDA). J Clin Psychiatry. 2010;71(12):1582–9.

    Article  PubMed  Google Scholar 

  25. Baune BT, Stuart M, Gilmour A, Wersching H, Heindel W, Arolt V, Berger K. The relationship between subtypes of depression and cardiovascular disease: a systematic review of biological models. Transl Psychiatry. 2012;2:e92.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  26. Byers AL, Vittinghoff E, Lui LY, Hoang T, Blazer DG, Covinsky KE, Ensrud KE, Cauley JA, Hillier TA, Fredman L, Yaffe K. Twenty-year depressive trajectories among older women. Arch Gen Psychiatry. 2012;69(10):1073–9.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Bunevicius A, Staniute M, Brozaitiene J, Bunevicius R. Diagnostic accuracy of self-rating scales for screening of depression in coronary artery disease patients. J Psychosom Res. 2012;72(1):22–5.

    Article  PubMed  Google Scholar 

  28. Beck AT, Steer RA, Brown GK. BDI-II: Beck depression inventory manual. San Antonio, TX: Psychological Corporation; 1996.

    Google Scholar 

  29. Suija K, Rajala U, Jokelainen J, Liukkonen T, Härkönen P, Keinänen-Kiukaanniemi S, Timonen M. Validation of the Whooley questions and the Beck Depression Inventory in older adults. Scand J Prim Health Care. 2012;30(4):259–64.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Beck AT, Guth D, Steer RA, Ball R. Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care. Behav Res Ther. 1997;35(8):785–91.

    Article  CAS  PubMed  Google Scholar 

  31. Frasure-Smith N, Lesperance F. Depression and anxiety as predictors of 2-year cardiac events in patients with stable coronary artery disease. Arch Gen Psychiatry. 2008;65(1):62–71.

    Article  CAS  PubMed  Google Scholar 

  32. Huffman JC, Doughty CT, Januzzi JL, Pirl WF, Smith FA, Fricchione GL. Screening for major depression in post-myocardial infarction patients: operating characteristics of the Beck Depression Inventory-II. Int J Psychiatry Med. 2010;40(2):187–97.

    Article  PubMed  Google Scholar 

  33. Norris MP, Arnau RC, Bramson R, Meagher MW. The efficacy of somatic symptoms in assessing depression in older primary care patients. Clin Gerontol. 2003;27:43–57.

    Article  Google Scholar 

  34. Wang YP, Gorenstein C. Assessment of depression in medical patients: a systematic review of the utility of the Beck Depression Inventory-II. Clinics (Sao Paulo). 2013;68(9):1274–87.

    Article  Google Scholar 

  35. Lichtman JH, Bigger Jr JT, Blumenthal JA, Frasure-Smith N, Kaufmann PG, Lespérance F, Mark DB, Sheps DS, Taylor CB, Froelicher ES, American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, American Heart Association Council on Clinical Cardiology, American Heart Association Council on Epidemiology and Prevention, American Heart Association Interdisciplinary Council on Quality of Care and Outcomes Research and American Psychiatric Association. Depression and coronary heart disease: recommendations for screening, referral, and treatment: a science advisory from the American Heart Association Prevention Committee of the Council on Cardiovascular Nursing, Council on Clinical Cardiology, Council on Epidemiology and Prevention, and Interdisciplinary Council on Quality of Care and Outcomes Research: endorsed by the American Psychiatric Association. Circulation. 2008;118(17):1768–75.

    Article  PubMed  Google Scholar 

  36. Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282(18):1737–44.

    Article  CAS  PubMed  Google Scholar 

  37. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Int Med. 2001;16:606–13.

    Article  CAS  Google Scholar 

  38. Choi NG, Sirey JA, Bruce ML. Depression in homebound older adults: recent advances in screening and psychosocial interventions. Curr Transl Geriatr Exp Gerontol Rep. 2013;2(1):16–23.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Diez-Quevedo C, Rangil T, Sanchez-Planell L, Kroenke K, Spitzer RL. Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosom Med. 2001;63(4):679–86.

    Article  CAS  PubMed  Google Scholar 

  40. Löwe B, Kroenke K, Herzog W, Gräfe K. Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord. 2004;81(1):61–6.

    Article  PubMed  Google Scholar 

  41. Löwe B, Unützer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Med Care. 2004;42(12):1194–201.

    Article  PubMed  Google Scholar 

  42. Huang FY, Chung H, Kroenke K, Delucchi KL, Spitzer RL. Using the Patient Health Questionnaire-9 to measure depression among racially and ethnically diverse primary care patients. J Gen Intern Med. 2006;21(6):547–52.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  43. Hepner KA, Morales LS, Hays RD, Edelen MO, Miranda J. Evaluating differential item functioning of the PRIME-MD mood module among impoverished black and white women in primary care. Womens Health Issues. 2008;18(1):53–61.

    Article  PubMed  Google Scholar 

  44. Yeung A, Fung F, Yu SC, Vorono S, Ly M, Wu S, Fava M. Validation of the Patient Health Questionnaire-9 for depression screening among Chinese Americans. Compr Psychiatry. 2008;49(2):211–7.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Poongothai S, Pradeepa R, Ganesan A, Mohan V. Reliability and validity of a modified PHQ-9 item inventory (PHQ-12) as a screening instrument for assessing depression in Asian Indians (CURES-65). J Assoc Physicians India. 2009;57:147–52.

    CAS  PubMed  Google Scholar 

  46. Lamers F, Jonkers CC, Bosma H, Penninx BW, Knottnerus JA, van Eijk JT. Summed score of the Patient Health Questionnaire-9 was a reliable and valid method for depression screening in chronically ill elderly patients. J Clin Epidemiol. 2008;61(7):679–87.

    Article  PubMed  Google Scholar 

  47. Kroenke K, Strine TW, Spitzer RL, Williams JB, Berry JT, Mokdad AH. The PHQ-8 as a measure of current depression in the general population. J Affect Disord. 2009;114(1–3):163–73.

    Article  PubMed  Google Scholar 

  48. Watson LC, Zimmerman S, Cohen LW, Dominik R. Practical depression screening in residential care/assisted living: five methods compared with gold standard diagnoses. Am J Geriatr Psychiatry. 2009;17(7):556–64.

    Article  PubMed Central  PubMed  Google Scholar 

  49. Chen S, Chiu H, Xu B, Ma Y, Jin T, Wu M, Conwell Y. Reliability and validity of the PHQ-9 for screening late-life depression in Chinese primary care. Int J Geriatr Psychiatry. 2010;25(11):1127–33.

    Article  PubMed  Google Scholar 

  50. Saliba D, DiFilippo S, Edelen MO, et al. Testing the PHQ-9 interview and observational versions (PHQ-9 OV) for MDS 3.0. J Am Med Dir Assoc. 2012;13:618–25.

    Article  PubMed  Google Scholar 

  51. Sheehan DV, Lecrubier Y, Sheehan KH, Amorim P, Janavs J, Weiller E, Hergueta T, Baker R, Dunbar GC. The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59 Suppl 20:22–33. quiz 34–57.

    PubMed  Google Scholar 

  52. Robins LN, Helzer JE, Croughan J, Ratcliff KS. National Institute of Mental Health Diagnostic Interview Schedule: its history, characteristics, and validity. Arch Gen Psychiatry. 1981;38:381–9.

    Article  CAS  PubMed  Google Scholar 

  53. Regier DA, Boyd JH, Burke Jr JD, Rae DS, Myers JK, Kramer M, Robins LN, George LK, Karno M, Locke BZ. One-month prevalence of mental disorders in the United States. Based on five Epidemiologic Catchment Area sites. Arch Gen Psychiatry. 1988;45(11):977–86.

    Article  CAS  PubMed  Google Scholar 

  54. Helzer JE, Robins LN. The diagnostic interview schedule: its development, evolution, and use. Soc Psychiatry Psychiatr Epidemiol. 1988;23(1):6–16.

    Article  CAS  PubMed  Google Scholar 

  55. World Health Organization. Composite International Diagnostic Interview (CIDI), Version 1.0. Geneva, Switzerland: World Health Organization; 1990.

    Google Scholar 

  56. Spitzer RL, Williams JBW, Gibbon M, et al. Structured Clinical Interview for the DSM-III-R. Washington, DC: American Psychiatric Press; 1990.

    Google Scholar 

  57. Williams JBW, Gibbon M, First MB, Spitzer RL, Davis M, Borus J, Howes MJ, Kane J, Pope HG, Rounsaville B, Wittchen H. The Structured Clinical Interview for DSM-III-R (SCID) II. Multi-site test-retest reliability. Arch Gen Psychiatry. 1992;49:630–6.

    Article  CAS  PubMed  Google Scholar 

  58. Lobbestael J, Leurgans M, Arntz A. Inter-rater reliability of the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) and Axis II Disorders (SCID II). Clin Psychol Psychother. 2011;18(1):75–9.

    Article  PubMed  Google Scholar 

  59. Segal DL, Kabacoff RI, Hersen M, Van Hasselt VB, Ryan CF. Update on the reliability of diagnosis in older psychiatric outpatients using the Structured Clinical Interview for DSM-III-R. J Clin Geropsychol. 1995;1:313–21.

    Google Scholar 

  60. Weertman A, Arntz A, Dreessen L, van Velzen C, Vertommen S. Short-interval test-retest interrater reliability of the Dutch version of the Structured Clinical Interview for DSM-IV personality disorders (SCID-II). J Pers Disord. 2003;17(6):562–7.

    Article  PubMed  Google Scholar 

  61. Wang L, Yuan C, Qiu J, Gunderson J, Zhang M, Jiang K, Leung F, Zhong J, Xiao Z. Reliability and validity of a Chinese version of the Diagnostic Interview for Borderlines-Revised. Asia Pac Psychiatry. 2014;6(3):326–33.

    Article  PubMed  Google Scholar 

  62. Sheehan KH, Sheehan DV. Assessing treatment effects in clinical trials with the discan metric of the Sheehan Disability Scale. Int Clin Psychopharmacol. 2008;23(2):70–83.

    Article  PubMed  Google Scholar 

  63. Fries JF, Bruce B, Cella D. The promise of PROMIS: using item response theory to improve assessment of patient-reported outcomes. Clin Exp Rheumatol. 2005;23(5 Suppl 39):S53–7.

    CAS  PubMed  Google Scholar 

  64. Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, Ader D, Fries JF, Bruce B, Rose M, PROMIS Cooperative Group. The Patient-Reported Outcomes Measurement Information System (PROMIS): progress of an NIH Roadmap cooperative group during its first two years. Med Care. 2007;45(5 Suppl 1):S3–11.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Hays RD, Bjorner JB, Revicki DA, Spritzer KL, Cella D. Development of physical and mental health summary scores from the patient-reported outcomes measurement information system (PROMIS) global items. Qual Life Res. 2009;18(7):873–80.

    Article  PubMed Central  PubMed  Google Scholar 

  66. Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R, PROMIS Cooperative Group. The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005–2008. J Clin Epidemiol. 2010;63(11):1179–94.

    Article  PubMed Central  PubMed  Google Scholar 

  67. PROsetta Stone®. PROsetta Stone® http://www.prosettastone.org. Accessed 15 Oct 2014.

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Authors and Affiliations

  1. Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, 3rd Floor, Boston, MA, 02115, USA

    Olivia I. Okereke M.D., M.S.

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Correspondence to Olivia I. Okereke M.D., M.S. .

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  1. Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School Boston, Boston, Massachusetts, USA

    Olivia I. Okereke

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Okereke, O.I. (2015). Measurement and Assessment in Late-Life Depression. In: Okereke, O. (eds) Prevention of Late-Life Depression. Aging Medicine, vol 9. Humana Press, Cham. https://doi.org/10.1007/978-3-319-16045-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-16045-0_6

  • Publisher Name: Humana Press, Cham

  • Print ISBN: 978-3-319-16044-3

  • Online ISBN: 978-3-319-16045-0

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