%0 Journal Article
%T The Validity of the WHO-5 as an Early Screening for Apathy in an Elderly Population
%A Ramona Lucas-Carrasco
%A Peter Allerup
%A Per Bech
%J Current Gerontology and Geriatrics Research
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/171857
%X Aim. The objective of our study has been to evaluate the WHO-5 as a new early screening instrument for apathy in a group of elderly persons. Methods. The WHO-5 was compared to the Geriatric Depression Scale (GDS-15). The GDS contains five items measuring well-being and ten items measuring depression. The internal validity of the WHO-5 (total score being a sufficient statistic) was evaluated with both parametric and nonparametric item response theory models. The external validity of the WHO-5 and the GDS was evaluated by ROC using depression as index of validity. Results. The item response theory analyses confirmed that the total score of the WHO-5 is a sufficient statistic. The ROC analysis shows an adequate sensitivity (61%) and specificity (84%). The GDS15 and its two subscales obtained low sensitivity (25¨C42%), but high specificity (90¨C98%). Conclusion. The WHO-5 was found both internally and externally valid when considering decreased positive well-being to be an early indication of apathy reflecting that the wind has begun to be taken out of the ¡°motivation sail.¡± 1. Introduction Cognitive disorders for example, dementia, stroke, Parkinson¡¯s Disease or epilepsy are often accompanied by noncognitive syndromes such as depression and apathy. Measures of depression severity or severity of apathy have been found useful by their differentiating between the overlapping non-cognitive symptoms and the cognitive symptoms in the clinical management of dementia, stroke, Parkinson¡¯s Disease, or epilepsy. Both depression and apathy are components of abulia, a term used by neurologists and neuropsychiatrists to denote lack of spontaneous goal-directed behaviour [1, 2]. The Geriatric Depression Scale (GDS) was developed by Yesavage et al. [3] and has been used in many clinical trials aimed at identifying depression in patients with cognitive disorders, especially dementia. Weeks et al. [4] reduced the original 30 item GDS to a 15 item version (GDS-15). The GDS-15 covers two subscales, namely, 10 items measuring specific depression symptoms and 5 items measuring psychological well-being. The syndrome of apathy was measured [5] by the Apathy Evaluation Scale (AES). This scale is still the only specific apathy scale. The AES contains 18 items. Three of these items are negatively formulated, such as lack of putting effort into anything (anergy). The remaining 15 items are all positively formulated. Eight of these items are concerned with being interested in things and 7 items cover initiative, motivation, or emotional contact. The term clinimetrics was introduced by
%U http://www.hindawi.com/journals/cggr/2012/171857/