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1.
BBA Clin ; 6: 108-12, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27635386

RESUMO

BACKGROUND: Despite the high incidence and mortality of ST-segment elevation myocardial infarction (STEMI) among the very elderly, risk markers for this condition remain poorly defined. This study was designed to identify independent markers of STEMI among individuals carefully selected for being healthy or manifesting STEMI in < 24 h. METHODS: We enrolled participants aged 80 years or older of whom 50 were STEMI patients and 207 had never manifested cardiovascular diseases. Blood tests, medical and psychological evaluations were obtained at study admission. Odds Ratio (OR) and attributed risk (AR) were obtained by multivariate regression models using STEMI as dependent variable. RESULTS: Low glomerular filtration rate (GFR) [OR:4.41 (1.78-10.95); p = 0.001], reduced levels of HDL-C [OR:10.70 (3.88-29.46); p = 0.001], male gender [OR:12.08 (5.82-25.08); p = 0.001], moderate to severe depressive symptoms [OR:10.00 (2.82-35.50); p = 0.001], prior smoking [OR:2.00 (1.05-3.80); p = 0.034] and current smoking [OR:6.58 (1.99-21.70); p = 0.002] were significantly associated with STEMI. No association was found between STEMI and age, diabetes, hypertension, mild depressive symptoms, triglyceride or LDL-C. CONCLUSIONS: This is the first case-control study carried out with very elderlies to assess STEMI risk. Our findings indicate that reduced HDL-C, GFR, male gender, smoking habits and moderate to severe depressive symptoms are markers of STEMI in this age group. GENERAL SIGNIFICANCE: In Individuals aged 80 or more years, a greater attention must be paid to low HDL-C and GFR at the expense of conventional STEMI risk factors for younger adults such as diabetes mellitus, hypertension and high LDL-C or triglyceride.

2.
Artigo em Espanhol | CUMED | ID: cum-62719

RESUMO

Introducción: La depresión constituye uno de los síndromes más frecuentes e incapacitantes de la población anciana constituyendo un importante problema de saludObjetivo: determinar la capacidad diagnóstica del cuestionario GDS de Yesavage abreviado versión española, como detector de depresión en población cubana de 60 años y más.Método: se realizó un estudio descriptivo transversal con una población de 101 pacientes a los cuales se les aplicó el cuestionario GDS de Yesavage abreviado versión española para detectar el posible padecimiento de depresión. Resultados: Predominó el sexo femenino (63.4 por ciento), el grupo de edad de 70-75 años (23.8 por ciento). El 42.6 por ciento de los pacientes padecerían de algún trastorno depresivo según el cuestionario GDS de Yesavage abreviado versión española siendo más frecuente en el grupo de edad de 65-69 años (64.7 por ciento) con una media de puntuación de 5.8 puntos. La escala demostró ser más sensible a partir de 4 puntos (84.6 por ciento) pero fue más específica a partir de 7 puntos (89.9 por ciento). El porcentaje de pacientes mal clasificados fue más elevado a partir de 4 puntos (28.7 por ciento). Estos parámetros fueron más fiables en paciente sin alteraciones cognitivas. La pregunta 3 del cuestionario fue la de mayor sensibilidad (72.1 por ciento) y la 1 la de mayor especificidad (91.4 por ciento). Conclusiones: El cuestionario GDS de Yesavage abreviado versión española resultó útil en el probable diagnóstico de depresión en población cubana mayor de 60 años(AU)


Introduction: Depression is one of the most common and disabling syndromes of the elderly population to be a major health problemObjective: To determine the diagnostic capability of the questionnaire GDS Yesavage abbreviated Spanish version, as detector of depression in Cuban population aged 60 and over. Methods: A cross-sectional study was conducted with a population of 101 patients who were administered the GDS questionnaire Yesavage abbreviated Spanish version to detect the possible suffering from depression. Results: There was a predominance of females (63.4 percent), the age group of 70-75 years (23.8 percent). 42.6 percent of patients may experience some depressive disorder according to the GDS questionnaire Yesavage abbreviated Spanish version is more frequent in the age group of 65-69 years (64.7 percent) with a mean score of 5.8 points. The scale proved to be more sensitive from 4 points (84.6 percent) but was more specific points from 7 (89.9 percent). The percentage of misclassified patients was higher from 4 points (28.7 percent). These parameters were more reliable in patients without cognitive impairment. Question 3 of the questionnaire was the highest sensitivity (72.1 percent) and the one of greater specificity (91.4 percent). Conclusions: The GDS Yesavage abbreviated Spanish version questionnaire was useful in the diagnosis of depression probably more Cuban population over 60 years(AU)


Assuntos
Humanos , Inquéritos e Questionários , Idoso/psicologia , Depressão/epidemiologia
3.
Diversitas perspectiv. psicol ; 10(1): 143-150, ene.-jun. 2014.
Artigo em Português | LILACS | ID: lil-747598

RESUMO

Observa-se que com o passar dos anos, o organismo humano passa por um processo natural de envelhecimento, gerando modificações funcionais, diminuindo a vitalidade e favorecendo o aparecimento de doenças relacionadas a esse período de vida. Os principais fatores de risco para o desenvolvimento da depressão no idoso compreendem aspectos genéticos, eventos estressantes, deterioro cognitivo associado à idade e alterações neurobiológicas, sendo que as taxas de prevalência de transtorno depressivo maior em idosos variam entre 2% a 5%. Idosos com sintomas depressivos e sintomas de ansiedade mais graves apresentaram déficits cognitivos. O objetivo desse estudo é verificar se há existe correlação entre significativa entre o desempenho cognitivo de idosos com sintomas de depressão, ansiedade e idade. Participaram desse estudo 231 idosos. O delineamento foi de um estudo quantitativo e transversal. Utilizou-se o Mini-Exame do Estado Mental (MEEM), a Escala de Depressão Geriátrica (GDS) e o Inventário de Ansiedade de Beck (BAI). Os resultados mostraram que a idade correlacionou-se de modo estatisticamente significativo e negativo com a pontuação no MEEM (r = -0.205, p <0.005), o que demonstra que ao avançar da idade, diminui o desempenho cognitivo. Os idosos com sintomas depressivos e sintomas de ansiedade mais graves apresentaram menores escores no MEEM.


Over time, the human body goes through a natural aging process, leading to functional changes, reducing vitality and fostering the emergence of diseases related to life span. The main risk factors for the development of depression in the elderly include genetics, stressful events, age-related cognitive deterioration and neurobiological abnormalities, with prevalence rates of major depressive disorder in the elderly range from 2% to 5%. Elderly people with depressive and anxiety symptoms had more severe cognitive deficits. The aim of this study is to ascertain whether there is significant correlation between the cognitive performance of elderly patients with symptoms of depression, anxiety and age. 231 seniors participated in this study. The design was a quantitative cross-sectional study and. We used the Mini-Mental State Examination (MMSE), Geriatric Depression Scale (GDS) and the Beck Anxiety Inventory (BAI). The results showed that age correlated statistically significantly and negatively with the MMSE score (r =-0.205, p <0.005), which shows that age reduced cognitive performance. Older people with depressive symptoms and more severe symptoms of anxiety had lower scores on the MMSE.


Se observa que en los últimos años, el cuerpo humano pasa por un proceso de envejecimiento natural, la generación de modificaciones funcionales, la reducción de la vitalidad; favoreciendo así la aparición de enfermedades relacionadas con ese periodo de la vida. Los principales factores de riesgo para el desarrollo de la depresión en los ancianos incluyen factores genéticos, los acontecimientos estresantes de la vida, el deterioro cognitivo asociado con el envejecimiento y las alteraciones neurobiológicas, con tasas de prevalencia del trastorno depresivo mayor en el rango de edad avanzada del 2% al 5%. Los adultos mayores con síntomas depresivos y síntomas de la ansiedad mostraron déficits cognitivos más severos. El objetivo de este estudio es verificar si existe una correlación significativa entre el rendimiento cognitivo de los adultos mayores con síntomas de la depresión, la ansiedad y la edad. 231 personas mayores participaron en este estudio. El diseño fue un estudio cuantitativo transversal. Se utilizó el Mini Examen del Estado Mental (MMSE), la Escala de Depresión Geriátrica (GDS) y el Inventario de Ansiedad de Beck (BAI). Los resultados mostraron que la edad y correlacionada estadísticamente significativamente asociada negativamente con la puntuación del MMSE (r = -0,205, p <0,005), demostrando que la edad, disminuyó el rendimiento cognitivo. Personas mayores con los síntomas depresivos y los síntomas de ansiedad severa tenían puntuaciones en el MMSE inferiores.

4.
Arch Phys Med Rehabil ; 94(12): 2509-2514, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23924438

RESUMO

OBJECTIVE: To examine associations between multitasking ability defined by performance on a complex task integrating multiple cognitive domains and vocational functioning in multiple sclerosis (MS). DESIGN: Survey data collection. SETTING: Laboratory with referrals from an outpatient clinic. PARTICIPANTS: Community-dwelling individuals with MS (N=30) referred between October 2011 and June 2012. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The modified Six Elements Test (SET) to measure multitasking ability, Fatigue Severity Scale to measure fatigue, several neuropsychological measures of executive functioning, and vocational status. RESULTS: Among the sample, 60% of individuals have reduced their work hours because of MS symptoms (cutback employment group) and 40% had maintained their work hours. Among both groups, SET performance was significantly associated with performance on several measures of neuropsychological functioning. Individuals in the cutback employment group demonstrated significantly worse overall performance on the SET (P=.041). Logistic regression was used to evaluate associations between SET performance and vocational status, while accounting for neuropsychological performance and fatigue. The overall model was significant (χ(2)3=8.65, P=.032), with fatigue [Exp(B)=.83, P=.01] and multitasking ability [Exp(B)=.60, P=.043] retained as significant predictors. CONCLUSIONS: Multitasking ability may play an important role in performance at work for individuals with MS. Given that multitasking was associated with vocational functioning, future efforts should assess the usefulness of incorporating multitasking ability into rehabilitation planning.


Assuntos
Atenção/fisiologia , Emprego , Função Executiva/fisiologia , Esclerose Múltipla/fisiopatologia , Adulto , Fadiga/fisiopatologia , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos
5.
Rev. Kairós ; 16(2): 307-316, jun. 2013.
Artigo em Português | Index Psicologia - Periódicos | ID: psi-64086

RESUMO

A desordem mental mais comum na terceira idade é a depressão. Os sintomas depressivos nem sempre se apresentam de maneira típica. Nos idosos as queixas somáticas são frequentes e podem ser reforçadas pela hospitalização, tornando os idosos mais suscetíveis ainda a sintomas depressivos. Isso se avigora numa ala geriátrica, onde os pacientes lá internados são muitas vezes mais frágeis, poliqueixosos, e com múltiplas comorbidades. Fundamentado a partir deste contexto, o presente trabalho teve como objetivo buscar reflexões críticas sobre o uso da Escala de Depressão Geriátrica (na versão reduzida - GDS-15), amplamente utilizada, como método para avaliar o quadro depressivo em idosos internados numa enfermaria de geriatria. Este estudo é, sobretudo, qualitativo, cuja coleta de informações envolveu a aplicação da escala proposta. Os resultados incitaram discussões acerca da necessidade de reavaliação da confiabilidade da Escala, podendo ser esta pouco suficiente/adequada para medir os sintomas depressivos destes pacientes específicos.(AU)


The most common mental disorder in the elderly is depression. Depressive symptoms are not always presented in a typical way. In depressed aged people multiple somatic complaints are frequently and can be reinforced by hospitalization, making the elderly more susceptible to depressive symptoms. This happens quite frequently in a geriatric ward, where patients admitted there are often more fragile, sensitive to pain and soreness, and with multiple comorbidities. Based on this context, this study aimed to look for critical reflections about the use of the Geriatric Depression Scale (reduced version - GDS-15), widely used as an evaluation method for assessing depression in elderly patients in a geriatric ward. This study is especially qualitative, in which the information gathered has involved application of the required scale. The results have prompted discussions about the need to reassess the reliability of the scale, making it not sufficient or appropriated to measure the depressive symptoms of these specific patients.(AU)


Assuntos
Humanos , Idoso , Idoso , Hospitalização , Depressão
6.
Rev. Kairós ; 16(2): 307-316, jun. 2013.
Artigo em Português | LILACS | ID: lil-768810

RESUMO

A desordem mental mais comum na terceira idade é a depressão. Os sintomas depressivos nem sempre se apresentam de maneira típica. Nos idosos as queixas somáticas são frequentes e podem ser reforçadas pela hospitalização, tornando os idosos mais suscetíveis ainda a sintomas depressivos. Isso se avigora numa ala geriátrica, onde os pacientes lá internados são muitas vezes mais frágeis, poliqueixosos, e com múltiplas comorbidades. Fundamentado a partir deste contexto, o presente trabalho teve como objetivo buscar reflexões críticas sobre o uso da Escala de Depressão Geriátrica (na versão reduzida - GDS-15), amplamente utilizada, como método para avaliar o quadro depressivo em idosos internados numa enfermaria de geriatria. Este estudo é, sobretudo, qualitativo, cuja coleta de informações envolveu a aplicação da escala proposta. Os resultados incitaram discussões acerca da necessidade de reavaliação da confiabilidade da Escala, podendo ser esta pouco suficiente/adequada para medir os sintomas depressivos destes pacientes específicos.


The most common mental disorder in the elderly is depression. Depressive symptoms are not always presented in a typical way. In depressed aged people multiple somatic complaints are frequently and can be reinforced by hospitalization, making the elderly more susceptible to depressive symptoms. This happens quite frequently in a geriatric ward, where patients admitted there are often more fragile, sensitive to pain and soreness, and with multiple comorbidities. Based on this context, this study aimed to look for critical reflections about the use of the Geriatric Depression Scale (reduced version - GDS-15), widely used as an evaluation method for assessing depression in elderly patients in a geriatric ward. This study is especially qualitative, in which the information gathered has involved application of the required scale. The results have prompted discussions about the need to reassess the reliability of the scale, making it not sufficient or appropriated to measure the depressive symptoms of these specific patients.


Assuntos
Humanos , Idoso , Idoso , Depressão , Hospitalização
7.
Arch Phys Med Rehabil ; 94(8): 1443-50, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23602881

RESUMO

OBJECTIVES: To investigate the effect of 2 standardized exercise programs, muscle strength exercises (SE) and aerobic exercises (AE), on the plasma levels of brain-derived neurotrophic factor (BDNF) and depressive symptoms in 451 elderly women. DESIGN: A randomized controlled trial. SETTING: Belo Horizonte/MG-Brazil. PARTICIPANTS: Community-dwelling older women (N=451; age, 65-89y). INTERVENTION: The participants were divided into 2 groups: SE and AE. Both protocols lasted 10 weeks, and 30 sessions (1-h sessions) in total were performed 3 times a week under the direct supervision of physical therapists. MAIN OUTCOME MEASURES: Plasma levels of BDNF (enzyme-linked immunosorbent assay) and depressive symptoms (Geriatric Depression Scale). RESULTS: There was a significant difference for BDNF plasma levels between the SE and AE groups (P=.009). Post hoc analysis revealed a pre-post intervention difference in BDNF levels only for the SE group (P=.008). A statistically significant difference was found for the pre- and postintervention Geriatric Depression Scale scores in both groups (P=.001), showing that the effects of both exercise protocols were comparable regarding depressive symptoms (P=.185). CONCLUSIONS: The present findings have demonstrated the positive effect of muscle strengthening and aerobic intervention on depressive symptoms in community-dwelling elderly women. Interestingly, only SE significantly increased the plasma levels of BDNF in our sample. The positive effects of physical exercise on depressive symptoms in the elderly were not mediated by BDNF.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/sangue , Transtorno Depressivo/sangue , Transtorno Depressivo/reabilitação , Exercício Físico , Fatores Etários , Idoso , Brasil , Estudos de Coortes , Feminino , Humanos , Fatores Sexuais
8.
Salud ment ; Salud ment;35(1): 71-77, ene.-feb. 2012. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-653863

RESUMO

Introduction Depression in the elderly is of interest because of its relationship with increased demand for health services, as well as the low frequency of diagnosis. Objective To determine the frequency of depressive symptoms (DS) among elderly beneficiaries in Mexico City by the revised scale of depression of the Center for Epidemiologic Studies of the United States (CES-DR) and the Yesavage Geriatric Depression Scale (GDS). Materials and methods In the first phase of the study we evaluated the presence of significant DS with the 30-item GDS. Those with scores of 11 or more were considered positive and were included in the second phase. In this phase were added a random sample with negative scores. All participants completed the second phase of the revised CES-DR. The 80 percentile was used in this study with a cut-off of 57 points. Results A total of 7449 elderly were included in the first phase. The prevalence of reported significant DS with the GDS was 21.7% (n = 1.616) (IC-95%, 20.4-23.0). The sample for the second phase included 2 923 elderly. The mean age was 70.8 years, 61.7% were women. Twelve percent (95% CI, 9.2-15.3) showed significant DS of major depression, 7.5% (95% CI, 6.3-8.9) was rated as probable, 17.2% (95% CI, 13.022.3) possible, 2.6% (95% CI, 2.2-3.1) sub-threshold depression episode and 60.7% (95% CI, 56.2-65.1) with no significant DS episodes of major depression. Significant frequency of major depression SD is presented using the GDS and CESDR was 6.5% (95% CI, 3.3-12.4). Conclusions The expression of the identified significant SD CES-DR is different from what is reported to the GDS. The CES-DR is more sensitive and specific to identify the presence of depressive symptoms.


Introducción La depresión en el anciano resulta de interés por su relación con el incremento de la demanda de servicios de salud, así como por su baja frecuencia de diagnóstico. Objetivo Determinar la frecuencia de los síntomas depresivos (SD) entre ancianos derechohabientes de la Ciudad de México, mediante la escala revisada de depresión del Centro de Estudios Epidemiológicos de los Estados Unidos (CES-DR) y la Escala de Depresión Geriátrica de Yesavage (GDS). Materiales y métodos En la primera fase del estudio se evaluó la presencia de SD significativos con la GDS de 30 ítems. Aquéllos con puntaje de 11 o más fueron considerados como positivos y se incluyeron en la segunda fase. En esta fase se agregó una muestra aleatoria con puntajes negativos. Todos los participantes en la segunda fase completaron la versión revisada del CES-DR. El percentil 80 se utilizó en este estudio con un punto de corte de 57 puntos. Resultados Un total de 7449 adultos mayores fueron incluidos en la primera fase. La prevalencia de SD significativos reportada con el GDS fue de 21.7% (n=1,616) (IC-95%, 20.4-23.0). La muestra para la segunda fase incluyó 2923 adultos mayores. La media de edad fue de 70.8 años, el 61.7% eran mujeres. El 12.0% (IC-95%, 9.2-15.3) presentó SD significativos de depresión mayor, 7.5% (IC-95%, 6.3-8.9) fue calificado como probable, 17.2% (IC-95%, 13.0-22.3) como posible, 2.6% (IC-95%, 2.2-3.1) con episodio de depresión sub-umbral y 60.7% (IC-95%, 56.265.1) sin SD significativos de episodios de depresión mayor. La frecuencia de SD significativos de depresión mayor que se presentó utilizando el GDS y el CESDR fue de 6.5% (IC-95%, 3.3-12.4). Conclusiones La expresión de SD significativos identificada con el CES-DR es diferente a lo que se reporta con el GDS. La CES-DR permite identificar la presencia de síntomas de depresión de manera más sensible y específica.

9.
Univ. psychol ; 10(3): 735-743, sep. 2011. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-650103

RESUMO

La escala para Depresión Geriátrica, de 5 y 15 ítems (GDS-5 y GDS-15), cuantifica síntomas depresivos en adultos mayores. Sin embargo, no se ha explorado el comportamiento psicométrico de la versión de cinco ítems en población colombiana. El presente trabajo se propuso estudiar la consistencia interna, la confiabilidad de constructo y la estructura factorial de la GDS-15 y de la GDS-5. Participaron en la investigación 105 adultos mayores colombianos y se calcularon: consistencia interna, confiabilidad de constructo y estructura factorial. La GDS-15 presentó consistencia interna de 0.78, confiabilidad de constructo de 0.87 y estructura bidimensional. La GDS -5 mostró consistencia interna de 0.73, confiabilidad de constructo de 0.83 y estructura unidimensional. En conclusión la GDS-5 muestra mejor comportamiento psicométrico que la GDS-15. Sin embargo, se recomienda desarrollar el diseño de una escala más confiable en esta población.


The Geriatric Depression Scale (GDS), 5 and 15-items version, are useful for identify depressive symptoms among elder people. However, psychometric properties of a version of five items has not explored among colombian elders. The aim of this paper was to study the internal consistency, the factor structure and the construct reliability of the GDS-15 and GDS-5. A total of 105 colombian people over 65 year-old participated in this investigation. The internal consistency, the construct reliability and the exploratory factor analysis were computed. The GDS-15 showed internal consistency of 0.78, the construct reliability of 0.87 and two-dimensional structure. The GDS-5 exhibited internal consistency of 0.73, construct reliability of 0.83 and one-dimensional structure. In conclusion the GDS-5 shows better psychometric properties than the GDS-15. However, it is recommended to develop the design a new and more reliability scale.

10.
Salud UNINORTE ; 24(1): 1-9, jun. 2008. tab
Artigo em Espanhol | LILACS | ID: lil-562486

RESUMO

Objetivo: Determinar la consistencia interna, la estructura factorial y la confiabilidad del constructo de la escala de Yesavage para depresión geriátrica (GDS-15) en adultos mayores asistentes a centros comunitarios de Cartagena (Colombia). Materiales y métodos: Estudio de validación de una escala para tamizaje sin criterio de referencia. Participaron 185 adultos mayores sin deterioro cognoscitivo, entre 65 y 95 años, con media de 75,6 (DT=6,9); y 57,3% mujeres. Se determinó consistencia interna mediante la fórmula 20 de Kuder-Richardson (KR-20) y se realizó análisis factorial exploratorio con el método de componentes principales. Resultados: La consistencia interna fue 0,783, la solución factorial mostró dos factores (estado de ánimo deprimido y capacidad de disfrute) que explicaban el 37,3% de la varianza y la confiabilidad del constructo fue 0,700. Conclusiones: La GDS - 15 muestra una aceptable consistencia interna y confiabilidad del constructo. No obstante, la estructura factorial bidimensional no es completamente satisfactoria. Es posible que la utilidad de la GDS-15 en personas de baja escolaridad sea limitada.


Objective: To determine the internal consistency, factor structure and construct reliability of the Yesavage Geriatric Depression Scale (GDS-15) among older people a ending community centers in Cartagena (Colombia). Materials and method: Validation study of a screening scale without a gold standard. A group of 185 adults participated in this research. Ages were between 65 and 95 years (Mean = 75.6, SD=6.9); and 57.3% were women. Internal consistency was determined by Kuder-Richardson’s formula 20, factor structure was explored by factor analysis with principal component method, and construct reliability was computed by Anderson-Gerbing’s formula. Results: Internal consistency was 0,783 and the factor solution showed two factors (depressed mood and life enjoy) that explained 37.3% of the variance, and construct reliability was 0,700. Conclusions: The GDS-15 showed acceptable internal consistency and construct reliability. However, its two-dimensional factor structure is not satisfactory. It is possible that the GDS- 15 exhibits low ability to identify depressive episodes in elders with low scholarship...


Assuntos
Centros Comunitários de Saúde , Estudos de Validação como Assunto , Transtorno Depressivo
11.
Gac. méd. Méx ; Gac. méd. Méx;143(2): 141-148, mar.-abr. 2007. tab
Artigo em Espanhol | LILACS | ID: lil-568789

RESUMO

La depresión es uno de los principales síndromes geriátricos. Es una enfermedad crónica o recurrente que tiene consecuencias devastadoras en el adulto mayor. La prevalencia es diferente según la metodología y la población de referencia utilizada, pero puede ser del 10 al 27%. En Estados Unidos, la depresión genera un gasto anual de 43 mil millones de dólares y los ancianos deprimidos parecen tener una mayor susceptibilidad para las enfermedades crónicas y el deterioro funcional. Las manifestaciones de la depresión en el anciano son fluctuantes y los síntomas somáticos tales como la fatiga, el insomnio y la anorexia predominan pero con poca especificidad ya que muchos adultos mayores, sin depresión, los pueden presentar. La detección temprana es deseable siempre y cuando los instrumentos usados para ello sean válidos y confiables. En este artículo se revisan las características clínicas sobresalientes y las consecuencias de la depresión en el adulto mayor. Además, se muestran las principales características metrológicas del instrumento más utilizado para su detección: la escala de depresión geriátrica(EDG). Una mejor comprensión de este problema permitirá un diagnóstico temprano y un tratamiento oportuno.


Among geriatric syndromes, chronic and recurrent depression is salient due to its ravaging effects. Depression is a predisposing factor for chronic diseases and decreases functional status. In the United States, depression alone represents a forty three billion dollar annual expense. Although the prevalence of depression may vary depending on the population studied and the methodology applied, its range is between 10 to 27%. Fatigue, insomnia, and anorexia, in a cyclical fashion, are the milestone symptoms of depression among the elderly. Nevertheless, these symptoms have poor diagnostic specificity, mainly because they may be observed among healthy elders; thus the importance of using reliable screening tools that allow early detection. In order to shed light on this disease, the present article reviews its clinical course and consequences, and describes the use of the geriatric depression scale as the most popular screening instrument for this patient population.


Assuntos
Humanos , Idoso , Depressão , Depressão/complicações , Depressão/diagnóstico , Depressão/psicologia , Inquéritos e Questionários
12.
J. bras. psiquiatr ; J. bras. psiquiatr;56(2): 102-107, 2007. tab
Artigo em Português | LILACS | ID: lil-465448

RESUMO

OBJETIVO: O objetivo deste estudo foi avaliar validade e fidedignidade da Escala de Depressão Gerißtrica (EDG) nas versões de 30 e 15 itens na identificação de suspeitas de depressão em idosos nas enfermarias de clínica médica do Hospital Universitßrio Lauro Wanderley, em João Pessoa, Paraíba. MÉTODOS: Realizou-se um estudo observacional e transversal, com aplicação da EDG-30 e da EDG-15 por uma entrevistadora treinada, efetuando-se no mesmo dia exame mental dos pacientes por um psiquiatra de acordo com critérios da CID-10. A fidedignidade das duas versões da EDG foi avaliada por meio da técnica do teste-reteste e da equivalência interobservadores. RESULTADOS: A concordância entre a aplicação da EDG30 e o exame psiquißtrico foi significativa e moderada (kappa = 0,48; p = 0,04), enquanto a EDG-15 não apresentou concordância estatística (p = 0,62). A EDG-30 apresentou sensibilidade de 83 por cento e especificidade de 57 por cento, mas a EDG-15 apresentou sensibilidade de 50 por cento e especificidade de 62 por cento. Os escores da EDG-30 apresentaram correlação estatisticamente significativa entre si no teste-reteste e na equivalência entre observadores, porém a versão de 15 itens não foi fidedigna. CONCLUSÕES: Conclui-se que a EDG-30 é mais sensível e fidedigna que a EDG-15. Assim, a EDG-30 é útil para detectar como negativos os pacientes que realmente não apresentem depressão, porém são necessßrios estudos posteriores para adequação dos itens dessa escala à nossa clientela, a fim de aumentar sua especificidade e valor preditivo positivo.


OBJECTIVE: The aim of this study was to evaluate the validity and reliability of the Geriatric Depression Scale (GDS) in the versions of 30 and 15 items for the identification of suspicion of depression in the elderly in the infirmary of general practice of the Hospital Universitßrio Lauro Wanderley, in João Pessoa, Paraíba. METHODS: An observational and transversal study, with the application of GDS-30 and GDS-15 by a trained interviewer, was held at the same day the mental exam of the patients by a psychiatrist, according to the criteria of ICD-10. The concordance of the two versions of the GDS was evaluated by the test-retest method and inter-observers equivalence. RESULTS: The concordance between the application of the GDS-30 and the psychiatric exam was significant and moderated (kappa = 0.48, p = 0.04), while the GDS-15 didn't present statistics concordance (p = 0.62). The GDS-30 presented sensitivity of 83 percent and specificity of 57 percent, but the GDS-15 presented sensitivity of 50 percent and specificity of 62 percent. Scores of GDS-30 presented significant statistically correlation in the test-retest method and inter-observers equivalence, but the version of 15 items weren't reliable. CONCLUSION: The conclusion was that the GDS-30 is more sensitive and reliable than the GDS-15, however its sensitivity was inferior to the numbers related in other studies, while his specificity was not high. Therefore, the GDS-30 is useful to detect as negatives the patients who really do not have depression, however further studies are necessary to adjust the items of this scale to our clientele, in order to enhance its specificity and positive predictive value.

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