Validity and Reliability of “AM SAD”, a Short Geriatric Depression Screening Tool, in Turkish Elderly People

Objective: Depression is a serious public health problem among the elderly and screening for depression in the elderly for primary care physicians is essential. The objective of this study was to evaluate the validity and reliability of the AM SAD (Appetite, Mood, Sleep, Activity, and thoughts of Death) and to compare the results with DSM-5 depression criteria in Turkish elderly people.

Methods: This study was conducted in a geriatric division of a tertiary hospital in the west part of Turkey, Izmir. A total of 186 elderly outpatients were included in the study. Translation from the original English version was performed according to the standardized methods. Yesavage Geriatric Depression-15 Scale (YGDS), and the “AM SAD” were administered following by the Mini-Mental Status Examination (MMSE). Patients were assessed for depression using DSM-5 criteria and the results were compared with AM SAD.

Results: A statistically significant correlation was established between YDGS-15 and AM SAD scores (r:0.64, p<0.001). AM SAD had also a mild-moderate statistically significant correlation with DSM-5 criteria that were depressive or not (r: 0.58 andr: 0.41, respectively). With a cut-off score of ≥ 2 points, the AM SAD showed sensitivity of 94% and specificity of 78% in the detection of depression in geriatric patients. The area under the receiver-operating characteristics curve (95% confidence interval) for the AM SAD was 0.92 (95% CI=0.873-0.968), p<0.001, kappa: 0.632. When cut-off point was selected as 3 points, sensitivity and specificity was found 70% and 95%, respectively (p<0.001, kappa: 0.692).

Conclusion: AM SAD which has a moderate correlation with DSM-5 criteria could be useful for screening depression in Turkish elderly patients in the primary care clinics. Although a cutoff score was 2, the cut-off score should be 3 if the appetite score is 2, because appetite affairs are quite common in elderly.