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      Psychometric Properties of Geriatric Depression Scale (Malay Version) in Elderly with Cognitive Impairment


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          Geriatric Depression Scale (GDS) has been widely used in assessing depression in elderly population. Using the Ministry of Health Malaysia definition for elderly, this study aimed to examine the construct validity and reliability of the GDS (Malay version) in elderly with cognitive impairment in Malaysia.


          A cross-sectional validation study involving 219 elderlies with cognitive impairment was conducted using universal sampling method. Participants aged 60 years old and above, scored less than 11 for the short mini mental state examination (SMMSE), have sufficient command of the Malay or English language, residing in the government nursing homes and attending memory clinics in government hospitals in Klang Valley were sampled. The GDS-15 English version underwent adaptation, translation, face validation and field testing to produce the Malay version. Psychometric analysis was performed using the exploratory factor analysis and its internal consistency was examined.


          Mean age of participants were 72.61 ± 7.79. Majority were male (50.7%), Malay (50.2%), studied at least until primary school (71.7%) and stayed at nursing homes (50.2%). Construct validity showed significant Bartlett’s test of sphericity (Chi-square = 1,340.058, P < 0.001) and Kaiser-Meyer-Olkin (KMO) test of 0.90. Factor loadings for each item in the depression domain were satisfactory ranging from 0.42 to 0.83. Factor loadings for each item in the psychosocial activities’ domain were satisfactory ranging from 0.53 to 0.76. For the questionnaire reliability analysis, the total Cronbach’s alpha for the final model was satisfactory, with and overall Cronbach’s alpha of 0.89. Cronbach’s alpha value for the depression and psychosocial activities domain was 0.861 and 0.80, respectively.


          The GDS (Malay version) is a valid and reliable tool to screen for depression in elderly with cognitive impairment.

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          Most cited references26

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          "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician.

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            Center for Epidemiologic Studies Depression Scale (CES-D) as a screening instrument for depression among community-residing older adults.

            The efficacy of the Center for Epidemiologic Studies Depression Scale (CES-D) as a screener for clinical depression was examined in a sample of 1,005 community-residing adults (age range = 50-96). Presence of a depressive disorder was determined by diagnostic interview. Analyses revealed that neither age, gender, cognitive impairment, functional impairment, physical disease, nor social desirability had a significant negative effect on the psychometric properties or screening efficacy of the CES-D. These results indicate that there was no significant degradation in the ability of the CES-D to screen for depression among community-residing elderly adults. This conclusion must be tempered by the fact that the sample did not include participants with the more disabling forms of cognitive or functional impairment and physical illness.
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              Cornell Scale for Depression in Dementia.

              The Cornell Scale for Depression in Dementia is introduced. This is a 19-item clinician-administered instrument that uses information from interviews with both the patient and a nursing staff member, a method suitable for demented patients. The scale has high interrater reliability (kw = 0.67), internal consistency (coefficient alpha: 0.84), and sensitivity. Total Cornell Scale scores correlate (0.83) with depressive subtypes of various intensity classified according to Research Diagnostic Criteria.

                Author and article information

                Malays J Med Sci
                Malays J Med Sci
                Malaysian Journal of Medical Sciences
                The Malaysian Journal of Medical Sciences : MJMS
                Penerbit Universiti Sains Malaysia
                June 2021
                30 June 2021
                : 28
                : 3
                : 97-104
                [1 ]Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
                [2 ]Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh, Selangor, Malaysia
                Author notes
                Correspondence: Associate Professor Dr Azlina Wati Nikmat, PhD (University of Melbourne, Australia), Head of Clinical Psychology Unit, Department of Psychiatry, Faculty of Medicine, Universiti Teknologi MARA, Jalan Hospital, 47000 Sungai Buloh, Selangor, Malaysia. Tel: +603 61267185, Fax: +603 61265224, E-mail: azlinawati@ 123456uitm.edu.my
                © Penerbit Universiti Sains Malaysia, 2021

                This work is licensed under the terms of the Creative Commons Attribution (CC BY) ( http://creativecommons.org/licenses/by/4.0/).

                : 12 July 2020
                : 25 January 2021
                Original Article

                depressive symptoms,elderly,cognitive dysfunction,validation,cognitive decline


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