AGE AND COGNITIVE IMPAIRMENT INFLUENCE THE PERFORMANCE OF THE GENERALHEALTH QUESTIONNAIRE

The General Health Questionnaire (GHQ) is a screening instrument desig ned to detect nonpsychotic psychiatric disorders. Its discriminating a bility can be influenced by factors such as the presence of physical i llness, comorbidity with other psychiatric disorders, and the presence of cognitive impairment, which are more frequent in the elderly. The present study examines the influence of age and cognitive impairment o n the performance of the GHQ-12, and was performed in the course of a family study designed to evaluate the risks for dementia, depression, and geriatric depression in the relatives of elderly subjects with dem entia of Alzheimer type or major depression. Four hundred subjects who had completed the GHQ-12 were included. Test performance was evaluate d by receiver-operating characteristic (ROC) analysis, Our results ind icate that (1) the GHQ-12 is applicable to elderly subjects (>65 years ), (2) its performance is comparable in different age groups, (3) the cutoff value for case identification is higher in the elderly (3/4) co mpared with younger individuals (1/2) and (4) mild cognitive impairmen t does not influence the good performance of the GHQ-12 in elderly sub jects. In conclusion, our study verifies the usefulness of the GHQ-12 as an instrument to identify states of depression; this applies also t o subjects with mild intellectual impairment. To optimize the discrimi native ability of the questionnaire, we propose the use of different c utoff values for the GHQ-12 score for case identification depending on the age of each individual. Copyright (C) 1997 by W.B. Saunders Compa ny.