Can we trust depression screening instruments in healthy 'old-old' adults?

Lea C. Watson, Carmen L. Lewis, Christine E. Kistler, Halle R. Amick, Malaz Boustani

Research output: Contribution to journalArticle

44 Scopus citations


Objective. Despite a growing understanding of late-life depression, few studies focus on the old-old, those 75 years and over. We wished to characterize depressive symptoms and determine the accuracy of two common screening instruments for major and minor depression in a population of old-old retirees. Methods. Participants lived independently in one of two Continuing Care Retirement Communities and volunteered for an in-home interview about cancer screening attitudes. As part of this baseline interview, they were screened with the Geriatric Depression Scale (GDS) and the Center for Epidemiologic Stuies-Depression (CES-D) scale. Those agreeing to a second interview received an evaluation using the Structured Clinical Interview for DSM-IV (SCID-IV), performed by a geriatric psychiatrist within two weeks of the initial interview. Results. In an educated and cognitively intact group of retirees averaging 80 years of age, the GDS and CES-D performed poorly using standard cutpoints in detecting both major (sensitivity 60% for both) and minor (sensitivity 33% and 50%, respectively) depression. One in five participants had significant depression as confirmed by SCID-IV evaluation. Twelve percent had major depression and 7% had minor depression. Most participants had their first episode of either after age 60. Conclusions. Contrary to most studies evaluating the GDS and CES-D for accuracy in detecting late-life depression, these instruments at standard cutpoints performed poorly in this group of healthy older adults. The healthy old-old may require novel screening interventions to detect clinically significant depression.

Original languageEnglish (US)
Pages (from-to)278-285
Number of pages8
JournalInternational Journal of Geriatric Psychiatry
Issue number3
StatePublished - Mar 1 2004


  • Depression
  • Late-life
  • Old-old
  • Screening instruments

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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