Dement Neurocogn Disord.  2015 Mar;14(1):24-30. 10.12779/dnd.2015.14.1.24.

The Relationship between Geriatric Depression Scale Structure and Cognitive-Behavioral Aspects in Patients with Alzheimer's Disease

• Kwak YT
• Song SH
• Yang Y

• KMID: 2443040
• DOI: http://doi.org/10.12779/dnd.2015.14.1.24

Abstract

BACKGROUND AND PURPOSE
Although the 15-item Geriatric Depression Scale (GDS15) is a widely used depression screening questionnaire, the implications of the GDS15 in patients with Alzheimer's disease (AD) are questionable. We designed this study to explore the GDS15 factor structure and the relationships between these factors and cognitive-behavioral aspects.
METHODS
The GDS15, cognitive function tests, and the Korean-Neuropsychiatry Inventory were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Three factors were identified by principal components analysis. A bivariate correlation analysis was conducted to determine the relationships between factors and neurocognitive and behavior symptoms.
RESULTS
Factor 2 was correlated with the Korean Boston Naming Test, calculating ability, the go-no-go test, the Controlled Oral Word Association Test (COWAT), the Color Word Stroop Test (CWST; words and color), aggression, depression, and apathy. Factor 3 was correlated with calculating ability, the Seoul Verbal Learning Test, immediate recall, copy, and delayed recall on the Rey-Osterieth Complex Figure Test, contrasting on the COWAT, and words and delusion on the CWST. We identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale.
CONCLUSIONS
These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggest multi-dimensional properties of the GDS15 in patients with AD.

Keyword

15-item Geriatric Depression Scale; Alzheimer's disease; Neuropsychiatry Inventory; factor analysis; cognitive function

MeSH Terms

Aggression
Alzheimer Disease*
Apathy
Delusions
Depression*
Factor Analysis, Statistical
Humans
Mass Screening
Memory, Short-Term
Seoul
Stroop Test
Verbal Learning
Word Association Tests
Surveys and Questionnaires

Reference

1. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983; 17:37–49.

2. Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS) recent evidence and development of a shorter version. Clinical Gerontologist. 1986; 1:165–173.

3. Shah AK, Phongsathorn V, Bielawska C, Katona C. Screening for depression among geriatric inpatients with short versions of the Geriatric Depression Scale. Int J Geriatr Psychiatry. 1996; 11:915–918.

4. D'Ath P, Katona P, Mullan E, Evans S, Katona C. Screening, detection and management of depression in elderly primary care attenders. I: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of short versions. Fam Pract. 1994; 11:260–266.

5. Bae JN, Cho MJ. Development of the Korean version of the Geriatric Depression Scale and its short form among elderly psychiatric patients. J Psychosom Res. 2004; 57:297–305.

6. Pomeroy IM, Clark CR, Philp I. The effectiveness of very short scales for depression screening in elderly medical patients. Int J Geriatr Psychiatry. 2001; 16:321–326.

7. Montorio I, Izal M. The Geriatric Depression Scale: a review of its development and utility. Int Psychogeriatr. 1996; 8:103–112.

8. Debruyne H, Van Buggenhout M, Le Bastard N, Aries M, Audenaert K, De Deyn PP, et al. Is the geriatric depression scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? Int J Geriatr Psychiatry. 2009; 24:556–562.

9. Parmelee PA, Lawton MP, Katz IR. Psychometric properties of the Geriatric Depression Scale among the institutionalized aged. Psychol Assess. 1989; 1:331–338.

10. Adams KB, Matto HC, Sanders S. Confirmatory factor analysis of the geriatric depression scale. Gerontologist. 2004; 44:818–826.

11. Adams KB. Depressive symptoms, depletion, or developmental change? Withdrawal, apathy, and lack of vigor in the Geriatric Depression Scale. Gerontologist. 2001; 41:768–777.

12. Sheikh JI, Yesavage JA, Brooks JO 3rd, Friedman L, Gratzinger P, Hill RD, et al. Proposed factor structure of the Geriatric Depression Scale. Int Psychogeriatr. 1991; 3:23–28.

13. Mitchell J, Mathews HF, Yesavage JA. A multidimensional examination of depression among the elderly. Research on Aging. 1993; 15:198–219.

14. Friedman B, Heisel MJ, Delavan RL. Psychometric properties of the 15-item geriatric depression scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients. J Am Geriatr Soc. 2005; 53:1570–1576.

15. Incalzi RA, Cesari M, Pedone C, Carbonin PU. Construct validity of the 15-item geriatric depression scale in older medical inpatients. J Geriatr Psychiatry Neurol. 2003; 16:23–28.

16. Brown PJ, Woods CM, Storandt M. Model stability of the 15-item Geriatric Depression Scale across cognitive impairment and severe depression. Psychol Aging. 2007; 22:372–379.

17. Havins WN, Massman PJ, Doody R. Factor structure of the Geriatric Depression Scale and relationships with cognition and function in Alzheimer's disease. Dement Geriatr Cogn Disord. 2012; 34:360–372.

18. Rovner BW, Broadhead J, Spencer M, Carson K, Folstein MF. Depression and Alzheimer's disease. Am J Psychiatry. 1989; 146:350–353.

19. Breen AR, Larson EB, Reifler BV, Vitaliano PP, Lawrence GL. Cognitive performance and functional competence in coexisting dementia and depression. J Am Geriatr Soc. 1984; 32:132–137.

20. Rubin EH, Kinscherf DA, Grant EA, Storandt M. The influence of major depression on clinical and psychometric assessment of senile dementia of the Alzheimer type. Am J Psychiatry. 1991; 148:1164–1171.

21. Wefel JS, Hoyt BD, Massma PJ. Neuropsychological functioning in depressed versus nondepressed participants with Alzheimer's disease. Clin Neuropsychol. 1999; 13:249–257.

22. Fahlander K, Berger AK, Bäckman L, Wahlin A. Depression does not aggravate the episodic memory deficits associated with Alzheimer's disease. Neuropsychology. 1999; 13:532–538.

23. Lopez OL, Boller F, Becker JT, Miller M, Reynolds CF 3rd. Alzheimer's disease and depression: neuropsychological impairment and progression of the illness. Am J Psychiatry. 1990; 147:855–860.

24. McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984; 34:939–944.

25. Kang Y, Na DL, Hahn S. A validity study on the Korean Mini-Mental State Examination (K-MMSE) in dementia patients. J Korean Neurol Assoc. 1997; 15:300–308.

26. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry. 1982; 140:566–572.

27. Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J. 1965; 14:61–65.

28. Kang Y, Na D. Seoul Neuropsychological Screening Battery (SNSB). Incheon: Human Brain Research & Consulting;2003.

29. Choi SH, Na DL, Kwon HM, Yoon SJ, Jeong JH, Ha CK. The Korean version of the neuropsychiatric inventory: a scoring tool for neuropsychiatric disturbance in dementia patients. J Korean Med Sci. 2000; 15:609–615.

30. Lyketsos CG, Steinberg M, Tschanz JT, Norton MC, Steffens DC, Breitner JC. Mental and behavioral disturbances in dementia: findings from the Cache County Study on Memory in Aging. Am J Psychiatry. 2000; 157:708–714.

31. Payne JL, Lyketsos CG, Steele C, Baker L, Galik E, Kopunek S, et al. Relationship of cognitive and functional impairment to depressive features in Alzheimer's disease and other dementias. J Neuropsychiatry Clin Neurosci. 1998; 10:440–447.

32. Schneider LS, Tariot PN, Lyketsos CG, Dagerman KS, Davis KL, Davis S, et al. National Institute of Mental Health Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE): Alzheimer disease trial methodology. Am J Geriatr Psychiatry. 2001; 9:346–360.

33. Zubenko GS, Zubenko WN, McPherson S, Spoor E, Marin DB, Farlow MR, et al. A collaborative study of the emergence and clinical features of the major depressive syndrome of Alzheimer's disease. Am J Psychiatry. 2003; 160:857–866.

34. Kwak YT, Yang Y, Pyo SJ, Koo MS. Clinical characteristics according to depression screening tools in patients with Alzheimer's disease: view from self, caregiver-reported and drug-intervention pattern. Geriatr Gerontol Int. 2014; 14:660–666.

35. Aron AR, Fletcher PC, Bullmore ET, Sahakian BJ, Robbins TW. Stop-signal inhibition disrupted by damage to right inferior frontal gyrus in humans. Nat Neurosci. 2003; 6:115–116.