A randomized controlled trial of the Geriatric Depression Scale in an inpatient ward for older adults

Objectives: To measure the prevalence of high scores on the Geriatric Depre ssion Scale in an Inpatient unit for older people and assess whether admini stration of this instrument Increased the use of antidepressant medication. Design: Randomized controlled trial. Setting: Inpatient unit for assessment, treatment and rehabilitation of old er adults in a district hospital. Subjects: Consecutive admissions to the inpatient unit were approached. Of 198 people, 100 gave consent and were randomized to receive the interventio n. Interventions: The Geriatric Depression Scale and the Folstein Mini-mental State Examination were administered to the Intervention group. The Nottingh am Instrumental Activities of Daily Living questionnaire and the Folstein M ini-mental Stale Examination were administered to the placebo group. The sc ores of these instruments and a copy of the completed instrument were place d In the subject's case notes. For those subjects randomized to receive the Geriatric Depression Scale an interpretation of the score was written in t he case notes. Main outcome measures: The primary outcome measure was whether antidepressa nt medication was listed on the discharge summary for the admission. Other outcome measures were death, readmission and use of antidepressant medicati on three months after administration of the instruments. Results. There was a prevalence of Geriatric Depression Scale scores greate r than 10 of 52% in the 50 people administered this Instrument. Six out of 46 people administered the Geriatric Depression Scale, who were discharged in the study period, were on antidepressant medication at discharge. Three out of 47 people administered the placebo instrument were on antidepressant medication at discharge. The absolute difference in proportions was 6.7%, 95% confidence interval 19 to -5.3%.