National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, No. 27, Nanwei Road, Xicheng District, Beijing, China.
BMC Geriatr. 2021 May 13;21(1):310. doi: 10.1186/s12877-021-02266-y.
The geriatric depression scale (GDS) is used widely as a screening instrument for depression worldwide. The present study aims to examine the reliability and validity of the GDS with 30 items (GDS-30) in Chinese cognitively normal elderly, and to preliminarily investigate the appropriateness of the GDS-30 among screened mild cognitive impairment (MCI) elderly and among the large-scale community-dwelling Chinese elderly.
A total of 12,610 Chinese elderly completed GDS-30 in the project of Community-based Cohort Study on Nervous System Diseases. Of these, 5503 individuals with the ability to perform basic daily living activities were randomly sampled to further complete the Montreal Cognitive Assessment to screen for MCI. The cutoff value of screened depression was 11, and the cutoff values of MCI were education-dependent. Internal consistency was used to evaluate the reliability. Exploratory factor analysis (EFA) was used to determine the factor structure. Confirmatory factor analysis (CFA) was conducted to assess the construct validity in the elderly screened normal cognition, screened MCI, and the whole population, respectively.
The Kuder-Richardson coefficient (KR20) was 0.834, 0.821 and 0.840 for the cognitively normal elderly, screened MCI and the whole population, respectively. EFA showed that GDS-30 can be either a four-factor model (named positive mood, dysphoria, worry, and social withdrawal-cognitive impairment) or a two-factor model (named depression and positive mood). The latter was easier to interpret. CFA showed that the two-factor model fitted well in the elderly with normal cognition, with screened MCI, and the whole sample. The factors loaded from 0.900 to 0.588, 0.882 to 0.529, and 0.888 to 0.556 in these three populations respectively.
The GDS-30 has good reliability and validity and can be appropriately applied to screen depression in the large-scale community-dwelling Chinese elderly regardless of the presence of mild cognitive impairment.
老年抑郁量表（GDS）被广泛用作全球范围内抑郁的筛查工具。本研究旨在检验 30 项老年抑郁量表（GDS-30）在中国认知正常老年人中的信度和效度，并初步探讨 GDS-30 在筛查轻度认知障碍（MCI）老年人和大规模社区居住的中国老年人中的适用性。
共有 12610 名中国老年人参加了神经系统疾病社区队列研究项目，完成了 GDS-30。其中，随机抽取 5503 名有能力进行基本日常生活活动的个体，进一步完成蒙特利尔认知评估，以筛查 MCI。筛查抑郁的截断值为 11，MCI 的截断值取决于教育程度。采用内部一致性评估信度，采用探索性因子分析（EFA）确定因子结构，采用验证性因子分析（CFA）分别在认知正常、筛查 MCI 和全人群中评估结构效度。
认知正常老年人、筛查 MCI 和全人群的 Kuder-Richardson 系数（KR20）分别为 0.834、0.821 和 0.840。EFA 显示，GDS-30 可以是一个四因素模型（命名为积极情绪、抑郁、担忧和社会回避认知障碍）或一个两因素模型（命名为抑郁和积极情绪）。后者更容易解释。CFA 显示，两因素模型在认知正常老年人、筛查 MCI 和全样本中拟合良好。在这三个群体中，因子的负荷分别为 0.900 到 0.588、0.882 到 0.529 和 0.888 到 0.556。
GDS-30 具有良好的信度和效度，可适用于大规模社区居住的中国老年人的抑郁筛查，无论是否存在轻度认知障碍。
