Department of Psychology, Pusan National University, Busan, Republic of Korea.
Department of Psychiatry, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Brain Behav. 2023 Mar;13(3):e2898. doi: 10.1002/brb3.2898. Epub 2023 Feb 8.
Assessment of depressive symptoms in older adults is challenging especially in the presence of risks in cognitive impairment. We aimed to examine whether the convergence between two measures of depressive symptoms (self-report and observer ratings) is affected by varying levels of cognitive function in older adults.
Self-reported scale of depression, informant-based rating of affective symptoms, and global cognitive function were assessed in 2533 older adults with no impairment, mild cognitive impairment, and Alzheimer's disease. The strength of rank-order correlation between the Geriatric Depression Scale (GDS) and behavioral ratings of the Neuropsychiatric Inventory (NPI) was examined as the metric of convergent validity.
The results showed that the strength of convergence between the two measurements gradually decreased as a function of lowered cognitive function. Overall tendency showed that diagnoses of cognitive impairment and lower levels of cognitive function were associated with lower correspondence between the two depression measurements. The loss of convergent validity is especially evident in the behavioral symptom of apathy.
Utilizing self-report scales of depression in older adults requires a cautious approach even with minimal or mild levels of cognitive impairment.
评估老年人的抑郁症状具有挑战性，尤其是在认知障碍风险存在的情况下。我们旨在研究在认知功能不同水平的情况下，两种抑郁症状评估方法（自评和观察评定）之间的一致性是否受到影响。
对 2533 名无认知障碍、轻度认知障碍和阿尔茨海默病的老年人进行了抑郁自评量表、基于知情者的情感症状评定和总体认知功能评估。使用老年抑郁量表（GDS）和神经精神问卷（NPI）的行为评定之间的等级相关强度作为收敛效度的指标。
结果表明，两种测量方法之间的一致性强度随着认知功能的降低而逐渐降低。总体趋势表明，认知障碍和认知功能水平较低的诊断与两种抑郁测量方法之间的对应性降低有关。在行为症状淡漠方面，收敛效度的丧失尤为明显。
即使在认知障碍或轻度认知障碍的情况下，使用老年人的自评抑郁量表也需要谨慎的方法。
