Is the center for epidemiologic studies depression scale as useful as the geriatric depression scale in screening for late-life depression? A systematic review

Abstract

Background: This study analyzed the predictive validity of the Center for Epidemiologic Studies Depression (CESD) scale for late-life depression (LLD) over the age of 50 years and identified the usefulness of the CES-D compared with the Geriatric Depression Scale (GDS). Methods: Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO databases using the following keywords: depression, depressive disorder, major, and the CES-D scale. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias. Results: We reviewed 22 studies, including 27,742 older adults aged 50+ years that met the selection criteria. In the meta-analysis, the pooled sensitivity was 0.81 in the CES-D long version and 0.76 in the short version. The sROC AUC was 0.89 (SE=0.01) for the long version and 0.88 (SE=0.04) for the short version. The GDS was only compared to the CES-D long version. The pooled sensitivity was as follows: the CES-D, 0.82; the GDS long version, 0.86; and the GDS short version, 0.87. Further, there was no heterogeneity of 0.0% between studies. The pooled specificity was 0.78 and 0.77, respectively, and the sROC AUC was 0.88 for the CES-D (SE=0.02), 0.89 for the GDS long version (SE=0.04), and 0.91 for the GDS short version (SE=0.03). Limitations: We could not consider cognitive function of older adults. Conclusions: The CES-D showed similar predictive validity compared to the GDS developed in older adults. The CES-D is a useful tool that can be used for LLD screening in older adults over 50 years old.