在认知功能水平各异的老年人社区样本中，比较患者报告结局测量信息系统抑郁量表与传统抑郁测量方法。
Comparing Patient-Reported Outcomes Measure Information System Depression Scale with Legacy Depression Measures in a Community Sample of Older Adults with Varying Levels of Cognitive Functioning.
作者信息
Levin Jennifer B, Aebi Michelle E, Smyth Kathleen A, Tatsuoka Curtis, Sams Johnny, Scheidemantel Thomas, Sajatovic Martha
机构信息
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH; Neurological and Behavioral Outcomes Center, University Hospitals Case Medical Center, Cleveland, OH.
Department of Psychiatry, Case Western Reserve University School of Medicine, Cleveland, OH.
出版信息
Am J Geriatr Psychiatry. 2015 Nov;23(11):1134-43. doi: 10.1016/j.jagp.2015.04.004. Epub 2015 Apr 22.
OBJECTIVE
This study evaluated the utility of Patient-Reported Outcomes Measure Information System Depression Scale (PROMIS-8a) compared with selected "Legacy" depression scales, including the Montgomery-Asberg Depression Rating Scale (MADRS), Geriatric Depression Scale (GDS), and GDS-Short Form (GDS-SF). Additionally, the measures' properties were assessed across levels of cognitive functioning.
METHODS
This cross-sectional analysis was extracted from a prospective cohort study. PROMIS-8a and Legacy depression measures were administered to individuals aged at least 70 years grouped by cognitive status based on the Saint Louis University Mental Status Examination. McNemar tests were run to determine if measures categorized the absence or presence of depression differently and item analysis evaluated classification discrepancies.
RESULTS
Sample mean age was 78, and most participants were women (71%), white (79%), with at least a high school education (89%). The percentage of individuals with at least mild depression was similar across measures (20.7% PROMIS-8a, 19.0% MADRS, 17.9% GDS, 13.9% GDS-SF). PROMIS-8a total score correlated moderately with MADRS (r = 0.56, df = 295, p <0.01), GDS (r = 0.68, df = 291, p <0.01), and GDS-SF (r = 0.60, df = 291, p <0.01), and predictive validity of the measures was similar. There were no significant mean differences on depression measures by cognitive status.
CONCLUSION
Although all measures identified a similar percent of depressed individuals, the classification differed by measure. Item analysis showed that PROMIS-8a was more likely to identify feelings of dysphoria while the MADRS and GDS were more likely to identify physiologic aspects of depression. Given the brevity and ease of administration of the PROMIS-8a, it appears to be a useful depression screen for community-dwelling older adults.
目的
本研究评估了患者报告结局测量信息系统抑郁量表（PROMIS - 8a）与选定的“传统”抑郁量表相比的效用，这些传统量表包括蒙哥马利 - 阿斯伯格抑郁评定量表（MADRS）、老年抑郁量表（GDS）和老年抑郁量表简表（GDS - SF）。此外，还评估了这些测量方法在不同认知功能水平下的特性。
方法
本横断面分析取自一项前瞻性队列研究。根据圣路易斯大学精神状态检查，将年龄至少70岁的个体按认知状态分组，对其进行PROMIS - 8a和传统抑郁测量。进行麦克尼马尔检验以确定各测量方法对抑郁的有无分类是否不同，项目分析评估分类差异。
结果
样本平均年龄为78岁，大多数参与者为女性（71%），白人（79%），至少具有高中文化程度（89%）。各测量方法中至少有轻度抑郁的个体百分比相似（PROMIS - 8a为20.7%，MADRS为19.0%，GDS为17.9%，GDS - SF为13.9%）。PROMIS - 8a总分与MADRS（r = 0.56，自由度 = 295，p <0.01）、GDS（r = 0.68，自由度 = 291，p <0.01）和GDS - SF（r = 0.60，自由度 = 291，p <0.01）中度相关，且各测量方法的预测效度相似。抑郁测量在认知状态方面无显著平均差异。
结论
尽管所有测量方法识别出的抑郁个体百分比相似，但分类因测量方法而异。项目分析表明，PROMIS - 8a更有可能识别烦躁不安的情绪，而MADRS和GDS更有可能识别抑郁的生理方面。鉴于PROMIS - 8a简短且易于实施，它似乎是社区居住老年人有用的抑郁筛查工具。
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