Can the Geriatric Depression Scale detect poststroke depression in Chinese elderly?

Background: Little is known about the performance of the Geriatric Depression Scale (GDS) in the screening of post-stroke depression (PSD) among Chinese elderly. Methods: Three months after the index stroke, a research assistant administered the 15-item GDS to 127 Chinese elderly patients with acute stroke who were consecutively admitted to a general hospital. A psychiatrist, who was blind to the GDS scores, administered the Structured Clinical Interview for DSM-IV to all patients and made DSM-IV diagnosis of depression, which served as the benchmark for judging the performance of GDS in screening PSD. Results: The optimal cut-off point of GDS was 6/7. The sensitivity, specificity, positive and negative predictive values of GDS and the area under the receiver operating characteristic curve, were 89, 73, 37, 98 and 90%, respectively. Limitations: The sample size was small and there was no separate analysis of the performance of GDS for subtypes of PSD. Conclusions: Due to its low positive predictive value, a more specific instrument should supplement GDS in screening PSD in Chinese elderly.