Poster Presentation
Thursday, 20 July 2006
10:00 AM - 10:30 AM
Thursday, 20 July 2006
3:00 PM - 3:30 PM
This presentation is part of : Poster Presentations II
Comparison of the Beck Depression Inventory and the Geriatric Depression Scale in an Elderly Cardiac Population
Claire Venker, BS, Heather Hiscox, MPH, and Shu-Fen Wung, PhD, MS, RN. College of Nursing, The University of Arizona, Tucson, AZ, USA
Learning Objective #1: identify appropriate depression scale for use in elderly cardiac populations.
Learning Objective #2: identify differences in depression scale applicability in diverse populations.
The Beck Depression Inventory (BDI) is commonly used to detect depressive symptoms in clinical and research settings but may not always be appropriate in a geriatric population.  The Geriatric Depression Scale (GDS) was developed to detect depressive symptoms in elderly populations.  To date no study has directly compared these two instruments.  The purpose of this study is to rate the agreement of these instruments in an elderly cardiac population.    
Methods:  This sub-analysis included 740 subjects with suspected myocardial infarction enrolled in a prospective study.  Those subjects that did not complete the BDI (version I) and GDS (GDS-15) were excluded.  Depressive symptoms were defined as a BDI score of 10 or greater or a GDS score of 5 or greater.  Kappa statistics were used to measure agreement in the overall population and in subgroups stratified by gender and ethnicity among those over age 65.  A level of significance (p value) of <0.05 was considered statistically significant. 
Results: Forty-four percent of subjects were 65 years or older.  Twenty-four percent of subjects expressed depressive symptoms captured on both instruments, while 57% of subjects were non-depressed on both instruments (kappa=0.579, p<0.001).  Using kappa statistics, the agreement between instruments for subjects under age 65 was 0.639 (p<0.001) and over age 65 was 0.473 (p<0.001).  Agreement varied by ethnicity among subjects over age 65.  Agreement was highest in Hispanics/Latinos (kappa=0.779, p<0.001), followed by non-Hispanic whites (kappa=0.433, p<0.001), and African Americans (kappa=0.467, p=0.009).  By gender, the agreement using kappa statistics in those over 65 was 0.459 (p<0.001) for men and 0.492 (p<0.001) for women. 
Conclusions:  The BDI and GDS have moderate agreement but agreement was better among those under age 65, indicating that the BDI is not as accurate in cardiac patients over age 65.  Among those over age 65, agreement was highest among Hispanics/Latinos and women.  

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