Screening for depression in older adults with cognitive impairment in the homecare setting: a systematic review

Abstract

Objective

Previous systematic reviews have examined depression screening in older adults with cognitive impairment (CI) in outpatient and inpatient clinics, nursing homes, and residential care. Despite an increasing number of older adults with CI receiving care in their homes, less is known about best depression screening practices in homecare. The objective of this review is to identify evidence-based practices for depression screening for individuals with CI receiving homecare by assessing tool performance and establishing the current evidence for screening practices in this setting.

Methods

This review is registered under PROSPERO (ID: CRD42018110243). A systematic search was conducted using MEDLINE, EMBASE, Health and Psychosocial Abstracts, PsycINFO and CINAHL. The following criteria were used: assessment of depression at home in older adults (>55 years) with CI, where performance outcomes of the depression screening tool were reported.

Results

Of 5,453 studies, only three met eligibility criteria. These studies evaluated the Patient Health Questionnaire (n = 236), the Geriatric Depression Scale (n = 79) and the Mental Health Index (n = 1,444) in older adults at home with and without CI. Psychometric evaluation demonstrated moderate performance in the subsamples of people with CI.

Conclusion

At present, there is insufficient evidence to support best practices in screening for depression in people with CI in homecare.

Keywords:

• Psychometrics
• evidence-based practice
• homecare
• depression
• cognitive impairment

Acknowledgements

We would like to acknowledge Jessica Babineau, BA, MLIS, for her invaluable assistance with the development of the search strategy and systematic search.

Author contributions

Study conception and ideas completed by IN and AI. IN and TA completed screening and data extraction. AI resolved any disagreements during screening and extraction. IN and AI completed data analysis and manuscript writing.

Disclosure statement

Dr. Iaboni has received research grants from the Alzheimer Association, AGE-WELL, Canadian Institute of Health Research, and Centre for Aging and Brain Health Innovation. She is on the scientific advisory panel for Winterlight LLC. No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was funded by the Walter and Maria Schroeder Institute for Brain Innovation and Recovery.