Yi-Chia Wei,1– 4 Li-Yuan Huang,1,2,5 Chemin Lin,1,2,6 Yu-Chiau Shyu,1,7 Chih-Ken Chen1,2,6
1Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung, Taiwan; 2College of Medicine, Chang Gung University, Taoyuan, Taiwan; 3Department of Neurology, Chang Gung Memorial Hospital, Keelung, Taiwan; 4Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan; 5Department of Nursing, Chang Gung Memorial Hospital, Keelung, Taiwan; 6Department of Psychiatry, Chang Gung Memorial Hospital, Keelung, Taiwan; 7Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
Correspondence: Chih-Ken Chen
Department of Psychiatry, Chang Gung Memorial Hospital at Keelung, No. 200 Lane 208, Jijin 1st Road, Anle District, Keelung City, 204, Taiwan
Tel +886-2-24329292-2725
Fax +886-2-24315931
Email kenchen@cgmh.org.tw
Background: Major depressive disorder (MDD) presents with emotional and somatic symptoms and sometimes subjective cognitive complaints (SCCs). This study developed a collaborative method to integrate SCC assessment for evaluating late-life MDD.
Methods: Residents aged > 50 years in the Community Medicine Research Center of Keelung Chang Gung Memorial Hospital in Taiwan during 2017– 2018 were prospectively recruited in this study. The participants were asked to report their depressive tendency and SCCs using the Taiwanese Depression Questionnaire (TDQ) and the AD8, respectively, and were administered psychiatric evaluation through the Mini–International Neuropsychiatric Interview (MINI). The participants were divided into elderly (age≥ 65 years) and older adult (age 50– 65) groups. The MDD predictive powers were assessed using logistic regression and receiver operating characteristic (ROC) curve analyses.
Results: Of the 118 enrolled participants (mean age: 64.81± 4.99, female-to-male ratio: 1.62), 9, 21, and 88 were categorized as those with current MDD, past MDD, and non-MDD on the basis of the MINI results, respectively. After adjustments for age, sex, and sleep quality, the TDQ score (odds ratio: 1.152, p=0.003) and AD8 score (odds ratio: 1.710, p=0.020) were used individually to predict current MDD. Overall, the TDQ individually predicted current MDD well with area under the ROC curve (AUC) of 0.835 (p=0.001). However, in the elderly group (N=63), the TDQ score did not identify current MDD well (AUC: 0.780, p=0.063). After co-considering SCCs, the linear combination of the sum of the TDQ score and four folds of the AD8 score could effectively distinguished elderly people with current MDD from those without it (AUC: 0.875, p=0.013)—with the cutoff of the aforementioned combined score being ≥ 32.
Conclusion: The self-reported response to the TDQ is a feasible approach of identifying MDD in community-dwelling people. Combining TDQ and AD8 scores further improved depression detection in elderly people.
Keywords: geriatric depression, major depressive disorder, Taiwanese Depression Questionnaires, subjective cognitive complaint, AD8
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