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PURPOSE: To compare the predictive validity of the Edinburgh Postnatal Depression Scale (EPDS) and other tools for screening depression in pregnant and postpartum women through a systematic review and meta-analysis. METHODS: An electronic search of MEDLINE, EMBASE, CINAHL, and PsycArticles databases was conducted using the following keywords: depression, perinatal-related terms, and EPDS. Quality Assessment of Diagnostic Accuracy Studies-2 was used to assess the risk of bias in diagnostic studies. RESULTS: The search identified 823 articles, of which 17 studies met the inclusion criteria. In 1831 pregnant women from nine studies, pooled sensitivity and specificity of the EPDS were 0.81 and 0.87, respectively, with summary receiver operating characteristic (sROC) curve of 0.90. In 515 postpartum women from six studies, pooled sensitivity, specificity, and sROC were 0.79, 0.92, and 0.90, respectively. We then compared the EPDS with other tools using three or more studies. The sROC curve of the Patient Health Questionnaire-9 was 0.74, which was lower than that (0.86) of the EPDS. The sROC curve of the Beck Depression Inventory and the ten-item Kessler Psychological Distress Scale was 0.91, similar to that of the EPDS (0.90 and 0.87). However, in comparison with the Postpartum Depression Screening Scale (0.98), the sROC curve of the EPDS was 0.54. CONCLUSION: As a tool specialized for screening depression in pregnant and postpartum women, the EPDS showed excellent performance. Thus, the EPDS can be used in preference to other tools to screen for depression in perinatal women at a primary care setting or a midwifery center.
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Depressão Pós-Parto , Feminino , Gravidez , Humanos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/psicologia , Depressão/diagnóstico , Programas de Rastreamento , Período Pós-Parto , Escalas de Graduação PsiquiátricaRESUMO
This study is an updated systematic review verifying whether the Center for Epidemiologic Studies Depression Scale (CES-D) is a valuable screening tool for children and adolescents. Electronic searches were performed on MEDLINE, EMBASE, CINAHL, and PsycArticles, using depression and CES-D as keywords. Fourteen studies that included 7,843 children and adolescents were analyzed. In the meta-analysis by CES-D type, the pooled sensitivity and specificity for the long version were 0.81 and 0.72, respectively; they were 0.80 and 0.74 for the short version, respectively. The summary receiver operating characteristic (sROC) curves were 0.83 and 0.86, respectively. Compared to the CES-D and other tools, the pooled sensitivity (0.84 vs. 0.83) and the pooled specificity (0.72 vs. 0.74) were similar, and the sROC curve was the same at 0.83. This review indicates that the CES-D is an available and valuable tool for screening depression in children and adolescents.
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This study confirms the effectiveness of aerobic exercise on waist circumference, Vo2 max, blood glucose, insulin, serum lipid in middle-aged women. The Ovid-Medline, Embase, the Cochrane Library, and CINAHL were searched. The risk of bias 2 revised in 2019 was used to assess the risk of bias in randomized controlled trials (RCTs). Selected studies were meta-analyzed with Review Manager 5.3. Data were compiled from 15 RCTs comprising 1,110 participants. Overall, aerobic exercise reduced waist circumference and blood glucose, and increased VO2 max significantly. We recommend the application of aerobic exercise to prevent metabolic disease in middle-aged women.
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Glicemia , Insulina , Feminino , Humanos , Pessoa de Meia-Idade , Exercício Físico , Lipídeos , Ensaios Clínicos Controlados Aleatórios como Assunto , Circunferência da CinturaRESUMO
OBJECTIVES: This up-to-date systematic review and meta-analysis aimed to examine the predictive validity of the Geriatric Depression Scale-15 (GDS-15) for screening depression in older adults aged over 65 years. METHODS: Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO database using the following keywords: depression, depressive disorder, major, geriatric depression scale, and geriatric depression scale short. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias in diagnostic studies. RESULTS: Thirty-one studies that included 8,897 older adults were analyzed. The pooled sensitivity of the GDS-15 was 0.80 (95% CI:0.78 to 0.82), its pooled specificity was 0.79 (95% CI:0.78 to 0.80), the area under the curve (AUC) was 0.89 (SE = 0.01) and the Q* value was 0.82 (SE = 0.01). The subgroup analysis revealed that the pooled sensitivity and specificity of the GDS-15 were higher in older adults with normal cognitive function than in those with cognitive impairment. CONCLUSIONS: These finding suggest that the GDS-15 may be more accurate for screening depression in older adults with normal cognitive function. CLINICAL IMPLICATIONS: The utility the GDS-15 may be restricted because its diagnostic accuracy is slightly lower among older adults with cognitive impairment.
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Depressão , Avaliação Geriátrica , Idoso , Depressão/diagnóstico , Humanos , Programas de Rastreamento , Escalas de Graduação Psiquiátrica , Sensibilidade e EspecificidadeRESUMO
AIMS: To review scientific evidence related to oral cryotherapy to prevent oral mucositis after cancer therapy. BACKGROUND: Oral mucositis is a common complication of cancer therapy. In the most severe form of oral mucositis, patients cannot eat or drink at all and must receive nutrition and fluid replacement through parenteral support. Topical cooling of the oral mucosa may be an option for the prevention of oral mucositis. DESIGN: Systematic review and meta-analysis. DATA SOURCES: The literature search was performed using the Ovid MEDLINE, Embase, Cochrane Library, and CINAHL Complete electronic databases for articles published up to 2017. The reference lists of all retrieved articles were manually reviewed to identify additional relevant studies. RESULTS: Of 353 publications, 15 randomized controlled trials, involving 919 cancer patients, conducted between 1994 and 2017 were included in the present meta-analysis. Oral cryotherapy, applied during treatment of solid cancers, led to a statistically lower level (P < .05) of oral mucositis overall, and of the more severe grades (3-4 and 2-4). CONCLUSIONS: Results of this study provide a scientific basis for oral cryotherapy as a viable nursing intervention that can significantly reduce the occurrence of severe oral mucositis.
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Antineoplásicos/efeitos adversos , Crioterapia , Neoplasias/terapia , Radioterapia/efeitos adversos , Estomatite/terapia , Humanos , Estomatite/etiologiaRESUMO
The prevention of falls among the elderly is arguably one of the most important public health issues in today's aging society. The aim of this study was to assess which tools best predict the risk of falls in the elderly. Electronic searches were performed using Medline, EMBASE, the Cochrane Library, CINAHL, etc., using the following keywords: "fall risk assessment", "elderly fall screening", and "elderly mobility scale". The QUADAS-2 was applied to assess the internal validity of the diagnostic studies. Selected studies were meta-analyzed with MetaDisc 1.4. A total of 33 studies were eligible out of the 2,321 studies retrieved from selected databases. Twenty-six assessment tools for fall risk were used in the selected articles, and they tended to vary based on the setting. The fall risk assessment tools currently used for the elderly did not show sufficiently high predictive validity for differentiating high and low fall risks. The Berg Balance scale and Mobility Interaction Fall chart showed stable and high specificity, while the Downton Fall Risk Index, Hendrich II Fall Risk Model, St. Thomas's Risk Assessment Tool in Falling elderly inpatients, Timed Up and Go test, and Tinetti Balance scale showed the opposite results. We concluded that rather than a single measure, two assessment tools used together would better evaluate the characteristics of falls by the elderly that can occur due to a multitude of factors and maximize the advantages of each for predicting the occurrence of falls.
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Acidentes por Quedas/prevenção & controle , Avaliação Geriátrica , Idoso , Humanos , Pacientes Internados , Medição de Risco/métodos , Fatores de Risco , Sensibilidade e EspecificidadeRESUMO
PURPOSE: Although the Braden Scale has been used as a basic tool to assess pressure ulcer risk, the validity of its effectiveness and accuracy was insufficient. Therefore, this study developed the groundwork for the predictive validity of the Braden Scale through a meta-analysis of prospective diagnosis assessment research. METHODS: Articles published between 1966 and 2013 from periodicals indexed in the Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the keyword 'pressure ulcer'. QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDiSc 1.4. RESULTS: Twenty-one diagnostic studies with high methodological quality, involving 6070 patients, were included. The meta-analysis revealed that the pooled sensitivity was 0.72 (95% CI 0.68, 0.75); pooled specificity was 0.81 (95% CI 0.80, 0.82), and the sROC AUC was 0.84 (SE = 0.02). A detail analysis confirmed that age and reference standards were the factors that affected the diagnostic accuracy of the Braden Scale. CONCLUSION: The results suggest that the Braden Scale has a moderate predictive validity. This research also revealed the possibility that the predictive validity of the Braden Scale could be enhanced if it was applied differently according to the attributes of the study subjects.
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Úlcera por Pressão/etiologia , Idoso , Hospitalização , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Reprodutibilidade dos Testes , Fatores de RiscoRESUMO
OBJECTIVE: This study attempted to show evidence of exercise programs as intervention to decrease depressive symptoms and to improve quality of life and self-esteem in older people. DESIGN: Systematic review of randomized controlled trials. DATA SOURCES: Electronic databases of KoreaMed, Korea Scientific and Technological Intelligence Center, Korean Society of Nursing Science, Korean Academy of Psychiatric Mental Health Nursing, Ovid-Medline and Embase were searched up to May 25th, 2012 for relevant articles. REVIEW: We searched studies of randomized controlled trials involving exercise programs administered to participants aged 65 years or over. Of 461 publications identified, 18 met the inclusion criteria for the meta-analysis. Quality assessment of the studies utilized Cochrane's Risk of Bias. RESULTS: Exercise therapy in older people was effective, as evidenced by a decrease in depressive symptoms [standardized mean difference (SMD) -0.36; 95% confidence interval (CI) -0.64, -0.08], and improvements in quality of life (SMD 0.86; 95% CI 0.11, 1.62) and self-esteem (SMD 0.49; 95% CI 0.09, 0.88). The changes were significant statistically, with no heterogeneity. CONCLUSIONS: Exercise programs in older people are effective in improving depressive symptoms, quality of life and self-esteem. Development and efficient use of tailored exercise programs for elderly people is a prudent strategy.
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Depressão/prevenção & controle , Exercício Físico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Autoimagem , Idoso , Humanos , República da CoreiaRESUMO
BACKGROUND: The Developmental Coordination Disorder Questionnaire (DCDQ) has been used to screen children who probably have developmental coordination disorder (DCD). AIMS: We systematically reviewed studies on the predictive validity of the DCDQ and performed a meta-analysis on its diagnostic accuracy. METHODS AND PROCEDURES: Literature was searched through four electronic databases: MEDLINE, Embase, CINAHL, and PsycArticles. A total of 27 studies was selected based on the inclusion criteria. The sensitivity and specificity of the DCDQ were assessed using summary receiver operating characteristic (sROC) curves. Subgroup analyses were conducted according to the DCDQ type, reference standard, and participant type. OUTCOMES AND RESULTS: Overall, the DCDQ has a sensitivity of 0.70 and a specificity of 0.77, showing moderate diagnostic accuracy (area under the curve, 0.80). Subgroup analysis showed that the revised version of the DCDQ had higher diagnostic accuracy than the original version. When the reference standard was the Diagnostic and Statistical Manual of Mental Disorders, the sensitivity and specificity of the DCDQ were 0.87 and 0.83, respectively. The diagnostic accuracy was higher in clinical samples compared to the general population. CONCLUSIONS AND IMPLICATIONS: This study demonstrated that the DCDQ has adequate diagnostic accuracy, suggesting it can help screen children with motor skill deficits.
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Transtornos das Habilidades Motoras , Sensibilidade e Especificidade , Criança , Humanos , Programas de Rastreamento/métodos , Transtornos das Habilidades Motoras/diagnóstico , Reprodutibilidade dos Testes , Curva ROC , Inquéritos e Questionários/normasRESUMO
Background: Diabetes mellitus (DM) has different prevalence by region. This study aimed to identify the differences in the effects of obesity and depression on DM in South Korean adults by region. Methods: The participants were 14,343 adults (≥30 yr) from Ulsan (regions with the lowest prevalence of DM) and Jeonbuk (regions with the highest prevalence of DM), and data were extracted from the Community Health Survey 2019. We applied a complex sampling design analysis to reflect the stratified, clustering and weights. The data were analyzed using the unweighted frequencies, weighted percentage, mean, standard error, Chi-Square test and multiple logistic regression analysis (SPSS 25.0). Results: Regarding the main result for Ulsan, the odds ratio of DM increased by 1.94, 2.52,1.57, and 4.87 times for obesity(25-29.9kg/m2), high obesity(≥30kg/m2), depression, and receipt of psychological counseling for depression, respectively. In Jeonbuk, the odds ratio of DM increased by 1.79, 2.84, and 3.59 times for obesity, high obesity, and unmet medical experience, respectively. On the other hand, depression-related variables were found to not influence DM. Conclusion: We provided the rationale for conducting a health project that interventions for obesity and depression should be included in DM management programs differently in Ulsan and Jeonbuk regions.
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OBJECTIVE: Dementia, a slowly progressive disease, is poorly diagnosed. One reason is that it is difficult to use the screening tools. The six-item cognitive impairment test (6-CIT) is brief, with six items, and has a confirmed scoring system that can easily be used by an average individual. This review aimed to analyze the predictive validity of the 6-CIT including comparisons with other tools such as the Mini-Mental State Examination (MMSE). METHODS: Literature searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycArticles using the dementia and 6-CITas keywords. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias. RESULTS: Seven studies with 6,831 participants that met the selection criteria were included. The pooled sensitivity of the 6-CIT analyzed in seven studies was 0.82 (95% CI 0.73-0.89), the pooled specificity was 0.87, and the summary receiver operating characteristic (sROC) curve was 0.90 (SE = 0.04). The diagnostic performance of the 6-CIT and MMSE was compared in three studies. The pooled sensitivity of the 6-CIT was 0.85, the pooled specificity was 0.91, and the sROC curve was 0.91, whereas the MMSE values were 0.70, 0.93, and 0.68, respectively. CONCLUSION: This review presents evidence that the 6-CIT has excellent dementia screening performance and could be used as a potential alternative to the MMSE. The 6-CIT may provide an opportunity for early detection of dementia.
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Disfunção Cognitiva , Demência , Humanos , Demência/diagnóstico , Curva ROC , Exame Neurológico , Disfunção Cognitiva/diagnósticoRESUMO
This systematic review aims, however, to determine which intervention is more effective. The skeletal muscle index (SMI), handgrip, and gait speed were used as indicators of improvement, and these effects were compared across six subgroups: combined intervention versus exercise; nutrition or control group; exercise versus nutrition; and exercise or nutrition versus control group. Out of 1596 articles, 32 studies (3063 older adults) were selected and meta-analyzed. Comparing the combined intervention with a control group, the WMD was 0.20 kg/m2, 1.56 kg, and 0.08 m/s for SMI, handgrip, and gait speed, respectively, all of which showed a statistically significant improvement. When a combined intervention was compared with exercise and nutrition, the former resulted in improvements in handgrip (WMD 0.38 kg) and gait speed (WMD 0.12 m/s). On comparing exercise and nutrition, there was an improvement in gait speed (0.12 m/s) with exercise alone. On comparing exercise with a control group, only handgrip (WMD 1.74 kg) and gait speed (WMD 0.11 m/s) showed improvement, whereas in the nutrition versus the control group, only the handgrip (WMD 0.90 kg) improved. Although exercise and nutritional therapy together demonstrated improved muscle strength, exercise is recommended for the improvement of physical performance.
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Sarcopenia , Humanos , Idoso , Sarcopenia/terapia , Força da Mão , Ensaios Clínicos Controlados Aleatórios como Assunto , Força Muscular , Exercício Físico/fisiologiaRESUMO
BACKGROUND: Home visits have often been performed for diabetes management, but with the increased use of the internet and smartphones, people are opting for telenursing as the main method for monitoring and controlling diabetes. OBJECTIVE: This study compares the effects of home visits and telenursing on diabetes management. METHODS: Four electronic databases (MEDLINE, Embase, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature) were used as data sources. Glycated hemoglobin (HbA1c), fasting blood sugar, and two-hour post-prandial glucose levels were used as outcome measures. A subgroup analysis was performed based on the type of diabetes and follow-up. RESULTS: Of 1890 studies, 24 (2801 participants) were selected and meta-analyzed. The nursing interventions provided during nursing visits or telenursing mainly included education on diabetes and blood sugar control. It was seen that HbA1c decreased with a weighted mean difference of -0.66 (95â¯% confidence interval -0.82 to -0.51, pâ¯<â¯.001) % in home visits and -0.56 (95â¯% confidence interval -0.81 to -0.31, pâ¯<â¯.001) % in telenursing. The fasting blood sugar reported only in telenursing was reduced by a weighted mean difference of -14.23 (95â¯% confidence interval 27.59 to -0.88, pâ¯=â¯.04) mg/dL and two-hour post-prandial glucose was reduced with a mean difference of -15.84 (95â¯% confidence intervalâ¯-24.45 to -7.24, pâ¯=â¯.003) mg/dL. Furthermore, low heterogeneity was found among the studies. In a subgroup analysis of diabetes type, HbA1c in home visits was reduced by -0.86â¯% in type 1 diabetes and -0.62â¯% in type 2 diabetes, while in telenursing, the reductions were -0.65â¯% and -0.53â¯%, respectively. Fasting blood glucose was reduced by -6.08â¯mg/dL and -18.50â¯mg/dL, respectively, whereas two-hour postprandial blood sugar was reduced by -14.49â¯mg/dL and -30.30â¯mg/dL, respectively, in telenursing. In the subgroup analysis of the follow-up period, HbA1c during home visits decreased by -0.63â¯% at 10 to 16â¯weeks, -0.73â¯% at 24 to 36â¯weeks, and -0.64â¯% at 52â¯weeks or more, while in telenursing, the reductions were -0.80â¯%, -0.44â¯%, and -0.07â¯%, respectively. Home visits were not statistically significant between 10 and 16â¯weeks, whereas telenursing was not significant at 52â¯weeks or more. CONCLUSIONS: Despite telenursing reducing HbA1c slightly less than home visits, evidence from this systematic review suggests that telenursing is a similarly effective approach for controlling blood glucose levels in patients with diabetes. Telenursing is a nursing intervention that can be used as an alternative to home visits for patients requiring diabetes management.
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Diabetes Mellitus Tipo 2 , Telenfermagem , Humanos , Glicemia/análise , Diabetes Mellitus Tipo 2/terapia , Hemoglobinas Glicadas , Visita Domiciliar , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
The current systematic review compared whether combined exercise and nutrition interventions are effective in preventing or improving sarcopenia in frail older adults and healthy older adults. Medline, Embase, Cochrane Library, and CINAHL were searched for randomized controlled trials. Of the 1,596 citations, 22 trials (N = 1,767) were included in the final sample. In frail older adults, significant improvement after combined exercise and nutrition interventions was observed in seven indicators: skeletal muscle index, 0.16 kg/m2; handgrip, 1.41 kg; knee extension strength, 0.24 Nm; five-repetition chair-stand test, -1.89 sec; gait speed, 0.06 m/s; Short Physical Performance Battery, 0.43; and Timed Up and Go test, -0.56 sec. In healthy older adults, two indicators improved and showed statistically significant differences: handgrip, 2.15 kg; and 6-Minute Walking Test, 9.71 m. Combined exercise and nutritional interventions can improve skeletal muscle quality, strength, and physical performance in frail and healthy older adults. [Research in Gerontological Nursing, 16(6), 312-320.].
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Sarcopenia , Humanos , Idoso , Sarcopenia/prevenção & controle , Força Muscular/fisiologia , Força da Mão , Idoso Fragilizado , Equilíbrio Postural , Estudos de Tempo e MovimentoRESUMO
BACKGROUND: Depression in older adults is a major disorder that can be triggering, exacerbating, or co-occurring with dementia symptoms. AIM: This study compared the diagnostic accuracy of the Cornell Scale for Depression in Dementia (CSDD) and the Geriatric Depression Scale (GDS), a depression screening tool developed for older adults. METHODS: Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO databases using the following keywords: dementia, depression, and CSDD. RESULTS: The pooled sensitivity of the CSDD and the GDS was 0.89 and 0.82, the pooled specificity was 0.88 and 0.85, and the summary receiver operating characteristic (SROC) curve was 0.94 and 0.91, respectively. In the subgroup analysis, the CSDD had the highest accuracy in the pooled sensitivity of 0.91, the pooled specificity of 0.87, and the sROC curve of 0.95 in the dementia group, and the GDS was the best in the non-dementia group at 0.88, 0.82, and 0.93, respectively. CONCLUSIONS: The CSDD showed high diagnostic accuracy in older adults with dementia, and the GDS in older adults without dementia.
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Demência , Depressão , Idoso , Demência/complicações , Demência/diagnóstico , Depressão/diagnóstico , Avaliação Geriátrica , Humanos , Escalas de Graduação Psiquiátrica , Sensibilidade e EspecificidadeRESUMO
Background: Type 2 diabetes (T2DM), a chronic disease, is associated with obesity and inflammation. This study investigated the effects of body mass index (BMI), leukocytes, and high-sensitivity C-reactive protein (hs-CRP) on type 2 diabetes mellitus in South Korean adults. Methods: Secondary analysis of data from 5,420 adults' subject in the Korea National Health and Nutrition Examination Survey (KNHANES VII-3, 2018) was performed. The collected data were analyzed by n (%), mean ± SD, t-test, χ2 -test, and multiple logistic regression methods. Results: BMI and leukocytes count were higher in the T2DM-diagnosed group. The probability of T2DM increased by 4.76 times for obesity compared to normal weight, but high obesity was not an influencing factor for T2DM. As the leukocytes increased, the probability of T2DM increased by 1.15 times. However, hs-CRP was not an influencing factor for T2DM. Age was higher in the T2DM-diagnosed group and appeared to be an influencing factor in T2DM. Conclusion: Obesity and inflammation indicators, including WBC, appeared to be risk factors for T2DM. This study presented the basis of diet and exercise interventions for weight loss and white blood cell count in a T2DM prevention and management program.
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BACKGROUND: Mild cognitive impairment (MCI) and Alzheimer's disease (AD) are screened to distinguish whether the cognitive decline in older adults is attributed to pathological causes rather than normal aging. OBJECTIVE: The purpose of this review was to analyze the diagnostic performance of the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) in screening for MCI and AD. METHODS: Electronic searches were performed on MEDLINE, EMBASE, CINAHL, and PsycArticles databases using the following keywords: dementia and ADAS-Cog. The Quality Assessment of Diagnostic Accuracy Studies-2 was used to check the risk of bias in the diagnostic studies. RESULTS: We reviewed 14 studies, including 3,875 patients who met the selection criteria. In 2,624 MCI patients from nine studies, the pooled sensitivity of ADAS-Cog was 0.80 (95% confidence interval [CI], 0.68-0.88), the pooled specificity was 0.84 (95% CI, 0.75-0.90), and the area under the curve of summary receiver-operating characteristic curves (SROC AUC) was 0.89 (SE = 0.03). In 2,517 AD patients from 10 studies, the pooled sensitivity and pooled specificity were 0.91 (95% CI, 0.86-0.95) and 0.93 (95% CI, 0.88-0.95), respectively, and the sROC AUC was 0.97 (SE = 0.01). Although sub-analyzed according to age and years of education, there was no significant difference in the predictive validity of the ADAS-Cog. CONCLUSION: The ADAS-Cog has high predictive validity as a screening tool in both MCI and AD and has better diagnostic performance in patients with AD. When early screening for AD is desired, ADAS-Cog is a first-stage screening tool that can be initially employed.
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Doença de Alzheimer , Disfunção Cognitiva , Idoso , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/psicologia , Cognição , Disfunção Cognitiva/diagnóstico , Disfunção Cognitiva/psicologia , Humanos , Testes Neuropsicológicos , Sensibilidade e EspecificidadeRESUMO
This review analyzes the predictive validity of the Cornell Scale for Depression in Dementia (CSDD), considering cognitive function. Electronic searches were performed using MEDLINE, EMBASE, CINAHL, and PsycINFO databases. Overall, 20 studies were reviewed, including 3,499 older adults, with and without dementia, who satisfied the selection criteria. Participants were stratified into the dementia, non-dementia, and mixed groups, and the diagnostic performance of the CSDD was assessed using receiver operating characteristic (ROC) curves. In the dementia and non-dementia groups, the area under the curve was ≥ 0.9, confirming high accuracy of the test. The pooled sensitivity was the highest in the dementia group (0.87), followed by the mixed group (0.84) and non-dementia group (0.82). In the subgroup analysis based on the Mini-Mental State Examination (MMSE), the ROC curve was 0.90 for older adults with MMSE scores < 15 and 0.87 for those with an MMSE score ≥ 15. Therefore, the CSDD can be considered excellent tool for assessing depression in all older adults, although its predictive ability is better for older adults with dementia compared to that in those without dementia. It can be used as a first-line screening tool for depression, regardless of cognitive function.
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Demência , Idoso , Demência/complicações , Demência/diagnóstico , Demência/psicologia , Depressão/diagnóstico , Humanos , Testes de Estado Mental e Demência , Escalas de Graduação Psiquiátrica , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: This study analyzed the predictive validity of the Center for Epidemiologic Studies Depression (CES-D) scale for late-life depression (LLD) over the age of 50 years and identified the usefulness of the CES-D compared with the Geriatric Depression Scale (GDS). METHODS: Electronic searches were performed on the MEDLINE, EMBASE, CINAHL, and PsycINFO databases using the following keywords: depression, depressive disorder, major, and the CES-D scale. The Quality Assessment of Diagnostic Accuracy Studies-2 was applied to assess the risk of bias. RESULTS: We reviewed 22 studies, including 27,742 older adults aged 50+ years that met the selection criteria. In the meta-analysis, the pooled sensitivity was 0.81 in the CES-D long version and 0.76 in the short version. The sROC AUC was 0.89 (SE=0.01) for the long version and 0.88 (SE=0.04) for the short version. The GDS was only compared to the CES-D long version. The pooled sensitivity was as follows: the CES-D, 0.82; the GDS long version, 0.86; and the GDS short version, 0.87. Further, there was no heterogeneity of 0.0% between studies. The pooled specificity was 0.78 and 0.77, respectively, and the sROC AUC was 0.88 for the CES-D (SE=0.02), 0.89 for the GDS long version (SE=0.04), and 0.91 for the GDS short version (SE=0.03). LIMITATIONS: We could not consider cognitive function of older adults. CONCLUSIONS: The CES-D showed similar predictive validity compared to the GDS developed in older adults. The CES-D is a useful tool that can be used for LLD screening in older adults over 50 years old.
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Depressão , Programas de Rastreamento , Idoso , Cognição , Estudos Epidemiológicos , Avaliação Geriátrica , Humanos , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Pesquisa , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: A systematic review was performed to identify the types of physical activities effective as interventions in preventing metabolic syndrome in middle-aged women. METHODS: Electronic databases (MEDLINE, EMBASE, the Cochrane Library, and CINAHL) served as the data sources. Cochrane's Risk of Bias 2 was applied to assess the risk of bias of the randomized controlled trials. Meta-analyses were performed on selected studies using Review Manager 5.3. Thirty-one trials enrolling 2,202 participants were included. RESULTS: Compared to controls, the effects of physical activity were indicated by pooled mean differences, which were -0.57 kg for body weight, -0.43 kg/m2 for body mass index, -1.63 cm for waist circumference, -4.89 mmHg for systolic blood pressure (BP), and -2.71 mmHg for diastolic BP. The effects were greater on the measurements of waist circumference and BP than on body weight and BMI. The types of physical activities were further analyzed according to sub-groups. Only aerobic exercise did not affect body weight and resistance exercise did not significantly change any results. Contrarily, combined exercises significantly reduced measurements of waist circumference and BP. CONCLUSION: This review can provide valuable information for research and implementation of measures to prevent metabolic syndrome in middle-aged women.