Depression Screening Tools in Older Adults of Diverse Cultural Backgrounds: A Scoping Review

Background/Purpose: Understanding the cultural conceptions of depression can guide its identification and management. We aimed to identify the scope of knowledge regarding depression screening tools in culturally diverse older adult populations.

Method: We performed a scoping review following PRISMA guidelines. We searched EMBASE, MEDLINE, and PsychINFO electronic databases. Independent reviewers screened titles and abstracts for inclusion/exclusion. Inclusion criteria: mean age ≤ 65 years, English language, validated depression screening tool, and identified ethnicity of sample. Exclusion criteria: participants with cognitive impairment, selective study populations (e.g. malignancy), victims of trauma, and caregivers.

Results: The search produced 7330 unique citations and 632 met inclusion criteria. After lull text review, 435 citations were included. Sixty-one countries were represented. Most studies were conducted in the USA (192), followed by South Korea (56), China (59), Hong Kong (24), and Japan (17). Eleven studies were performed in Canada. One-hundred-forty cultural/ethnic categories were reported. Thirty-three depression screening tools were identified. The most commonly used screening tool was the Center for Epidemiologic Studies-Depression Scale (188, used in 43.2% of all studies), followed by the Geriatric Depression Scale (164, 37.7%) and the Patient Health Questionnaire (61, 14.0%). Canadian studies favoured the GDS (58%) and often used translated versions of the GDS for non-English speaking participants.

Discussion: We explored the scope of knowledge regarding depression screening tools in culturally and ethnically diverse populations. Knowing which screening tools have been studied in diverse populations may guide the selection of the most appropriate tool and improve patient-centred care.

Conclusion: Despite broad clinical use, not all commonly used depression screening tools have been studied in the ethnic and cultural groups in which they are utilized. It is important to be aware of the limitations of such screening tools.