Research Area:  Machine Learning

Abstract:

To compare the diagnostic accuracy of depression case finding tools with a criterion standard in the outpatient setting among adults with dementia.Systematic review and meta-analysis.Studies of older outpatients with dementia.Elderly outpatients (clinic and long-term care) with dementia (N = 3,035).Prevalence of major depression and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios.From the 11,539 citations, 20 studies were included for qualitative synthesis and 15 for a meta-analysis. Tools included were the Montgomery Åsberg Depression Rating Scale, Cornell Scale for Depression in Dementia (CSDD), Geriatric Depression Scale (GDS), Center for Epidemiologic Studies Depression Scale (CES-D), Hamilton Depression Rating Scale (HDRS), Single Question, Nijmegen Observer-Rated Depression Scale, and Even Briefer Assessment Scale–Depression. The pooled prevalence of depression in individuals with dementia was 30.3% (95% CI = 22.1–38.5). The average age was 75.2 (95% CI = 71.7–78.7), and mean Mini-Mental State Examination scores ranged from 11.2 to 24. The diagnostic accuracy of the individual tools was pooled for the best-reported cutoffs and for each cutoff, if available. The CSDD had a sensitivity of 0.84 (95% CI = 0.73–0.91) and a specificity of 0.80 (95% CI = 0.65–0.90), the 30-item GDS (GDS-30) had a sensitivity of 0.62 (95% CI = 0.45–0.76) and a specificity 0.81 (95% CI = 0.75–0.85), and the HDRS had a sensitivity of 0.86 (95% CI = 0.63–0.96) and a specificity of 0.84 (95% CI = 0.76–0.90). Summary statistics for all tools across best-reported cutoffs had significant heterogeneity.There are many validated tools for the detection of depression in individuals with dementia. Tools that incorporate a physician interview with patient and collateral histories, the CSDD and HDRS, have higher sensitivities, which would ensure fewer false-negatives.

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Author(s) Name:  Zahra S. Goodarzi, Bria S. Mele BA&Sc,Derek J. Roberts,Jayna Holroyd-Leduc

Publisher name:  Wiley

DOI:  10.1111/jgs.14713

Volume Information:  Volume65, Issue5

Paper Link:   https://agsjournals.onlinelibrary.wiley.com/doi/abs/10.1111/jgs.14713