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Development and validation of the Chinese Geriatric Depression Risk calculator (CGD-risk): A screening tool to identify elderly Chinese with depression
Collin Sakal1; Juan Li2; Yu-Tao Xiang3; Xinyue Li1
2022-12-15
Source PublicationJOURNAL OF AFFECTIVE DISORDERS
ISSN0165-0327
Volume319Pages:428-436
Abstract

Background: The prevalence of depression among China's elderly is high, but stigma surrounding mental illness and a shortage of psychiatrists limit widespread screening and diagnosis of geriatric depression. We sought to develop a screening tool using easy-to-obtain and minimally sensitive predictors to identify elderly Chinese with depressive symptoms (depression hereafter) for referral to mental health services and determine the most important factors for effective screening. Methods: Using nationally representative survey data, we developed and externally validated the Chinese Geriatric Depression Risk calculator (CGD-Risk). CGD-Risk, a gradient boosting machine learning model, was evaluated based on discrimination (Concordance (C) statistic), calibration, and through a decision curve analysis. We conducted a sensitivity analysis on a cohort of middle-aged Chinese, a sub-group analysis using three data sets, and created predictor importance and partial dependence plots to enhance interpretability. Results: A total of 5681 elderly Chinese were included in the development data and 12,373 in the external validation data. CGD-Risk showed good discrimination during internal validation (C: 0.81, 95 % CI 0.79 to 0.84) and external validation (C: 0.77, 95 % CI: 0.76, 0.78). Compared to an alternative screening strategy CGD-Risk would correctly identify 17.8 more elderly with depression per 100 people screened. Limitations: We were only able to externally validate a partial version of CGD-Risk due to differences between the internal and external validation data. Conclusions: CGD-Risk is a clinically viable, minimally sensitive screening tool that could identify elderly Chinese at high risk of depression while circumventing issues of response bias from stigma surrounding emotional openness.

KeywordDepression Machine Learning Prediction China Geriatrics
DOI10.1016/j.jad.2022.09.034
URLView the original
Indexed BySCIE ; SSCI
Language英語English
WOS Research AreaNeurosciences & Neurology ; Psychiatry
WOS SubjectClinical Neurology ; Psychiatry
WOS IDWOS:000870046800005
PublisherELSEVIER, RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
Scopus ID2-s2.0-85138800399
Fulltext Access
Citation statistics
Document TypeJournal article
CollectionDEPARTMENT OF PUBLIC HEALTH AND MEDICINAL ADMINISTRATION
Faculty of Health Sciences
Institute of Translational Medicine
Corresponding AuthorXinyue Li
Affiliation1.School of Data Science, City University of Hong Kong, Hong Kong, SAR, China
2.Center on Aging Psychology, Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
3.Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
Recommended Citation
GB/T 7714
Collin Sakal,Juan Li,Yu-Tao Xiang,et al. Development and validation of the Chinese Geriatric Depression Risk calculator (CGD-risk): A screening tool to identify elderly Chinese with depression[J]. JOURNAL OF AFFECTIVE DISORDERS, 2022, 319, 428-436.
APA Collin Sakal., Juan Li., Yu-Tao Xiang., & Xinyue Li (2022). Development and validation of the Chinese Geriatric Depression Risk calculator (CGD-risk): A screening tool to identify elderly Chinese with depression. JOURNAL OF AFFECTIVE DISORDERS, 319, 428-436.
MLA Collin Sakal,et al."Development and validation of the Chinese Geriatric Depression Risk calculator (CGD-risk): A screening tool to identify elderly Chinese with depression".JOURNAL OF AFFECTIVE DISORDERS 319(2022):428-436.
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