Screening for depression in older adults

Pocklington, Claire

June 2016

Thesis or dissertation

© 2016 Claire Pocklington. All rights reserved. No part of this publication may be reproduced without the written permission of the copyright holder.

Despite being the most common mental disorder in older adults, depression is under-recognised. It poses diagnostic difficulties in this population for several reasons; for example, symptomatic and phenomenological differences, age-related biological and psychological factors, and the presence of physical comorbidities. Depression in older adults is an important clinical topic because outcomes are worse in comparison to younger adults. It is also associated with higher rates of morbidity and mortality, increased healthcare utilisation and economic costs. It is likely to become a more pressing issue in the future due to the projected increase in the older adult population.

Screening for depression could be a solution to improve detection rates and avert the negative consequences of depression. This dissertation explores the topic of screening for depression in older adults. It uses systematic review methods to examine two questions. First, what is the diagnostic accuracy of the Geriatric Depression Scale? Secondly, what is the clinical effectiveness of screening for depression in older adults?

Findings of this dissertation show that the diagnostic performance of the Geriatric Depression Scale, at the recommended cut-off score of 5, is acceptable for screening purposes. However, results suggest the possibility of selective reporting of cut-off scores post-hoc and therefore findings should be approached cautiously. The dissertation found limited evidence regarding the clinical effectiveness of screening for depression in older adults and therefore cannot make any recommendations for policy or practice.

[Thesis includes article from International journal of geriatric psychiatry, available at: ]

Hull York Medical School, The University of Hull and University of York
McMillan, Dean
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