Depression identification among nursing home residents: The GDS vs. the MDS

The purpose of the present study was to investigate whether the Geriatric Depression Scale (GDS) is a better tool for identifying depression among nursing home residents than is the Minimum Data Set (MDS). More specifically, it examined whether the GDS more accurately identified depressed residents than (a) if only one item from section E1 was rated, (b) the OSCAR rating for depression, (c) the QI rating for depression. This study also compared the SADS-RDC with the GDS in order to validate the GDS as an adequate identification tool for depression. Three hundred forty-eight nursing home residents from the Isabella Geriatric Center were screened for depression using the GDS and the MDS. The Schedule for Affective Disorders and Schizophrenia - Research Diagnostic Criteria (SADS-RDC) was administered to 38 residents in order to validate the GDS. Based on sample descriptives for depression, the GDS identified more depressed individuals than the MDS Section E1, the QI, or the OSCAR. Thirty-five percent were identified as depressed with the GDS, whereas 23%, 3%, and 4% were identified as depressed with the MDS Section E1, QI, and the OSCAR, respectively. Chi square and correlational comparisons indicated the GDS was the better test, in relation to the SADS-RDC for identifying depressed residents than was the MDS. As predicted, the comparisons showed there was a strong relationship between the SADS-RDC and the GDS, but not for the various indices of the MDS. Mean sensitivity and specificity were also compared and results indicated that the mean sensitivity and specificity for the SADS-RDC vs. GDS Total Score = 6 (the standard cut-off for depression) was the highest at .91, followed by the various indices of the MDS: QI at .88, OSCAR at .83, and MDS Section E1 at .79. As predicted, the GDS was a better tool for identifying depression among nursing home residents at the Isabella Geriatric Center than was the MDS. This is important because the MDS is the standard measure used to develop care plans for depression in long-term care facilities. This study showed that current depression identification among nursing home residents may not be adequate