Section - Video Lectures

02. Later-Life Depression Scales: PHQ-9, Suicide Risk Checklist, and MoCA

Published on February 1, 2021 Expired on April 1, 2025

Charles F. Reynolds III, M.D.

Editor, American Journal of Geriatric Psychiatry Distinguished Professor of Psychiatry emeritus - University of Pittsburgh School of Medicine

Key Points

Measurement-based care is critical for diagnosing major depression and the assessment of treatment efficacy and safety.
Symptoms of depression and cognitive function can be assessed with the PHQ-9 and MoCA.
Scores on rating scales can be monitored over time to gauge treatment response.
Checking for risk and protective factors for suicide is critical and should include collateral information from the family.

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Slides and Transcript

Slide 1 of 15

The next part of our conversation together deals with the measurement of depression in older adults. And here, the fundamental theme that I want to address with you has to do with what has been called measurement-based care. And I’m going to emphasize the central importance of measurement-based care both for diagnosis, for treatment and for prevention. The important point is to employ the tools of measurement-based care which there are several.

Later-Life Depression Scales: PHQ-9, Suicide Risk Checklist, and MoCA Slide 1 of 15

Slide 2 of 15

Our favorites are the Patient Health Questionnaire-9 or the PHQ-9 as it is called and the MoCA, the Montreal Cognitive Assessment instrument as we put a great deal of emphasis on measuring both the symptoms of depression as well as the patient’s cognitive status via the use of the screening tools. But other important instruments that I would like to mention are a suicide risk checklist that we’ve developed at Pittsburgh essentially functioning, as our colleague Atul Gawande has written about so eloquently, as a means of conducting a thorough review of the risk and protective factors for suicide that are frequently present in older adults with major depression. And I’ll mention briefly the Cornell Rating Scale for Depression in Dementia which is the state-of-the-art scale for measuring depression-like behaviors or symptoms in persons living with dementia.

References:

Reynolds, C. F. (2017). Evidence-Based Treatment and Prevention of Major Depressive Episodes in Later Life. In Halter, J. B., Ouslander, J. G., Studenski, S., High, K. P., Asthana, S., Supiano, M. A., Ritchie C. (Eds.), Hazzard's geriatric medicine and gerontology (7th ed., pp. 1071–1088). essay, McGraw-Hill Education Medical.

Later-Life Depression Scales: PHQ-9, Suicide Risk Checklist, and MoCA Slide 2 of 15

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03. Remission, Functional Recovery, and Prevention of Relapse and Recurrence of Later-Life Depression

Learning Objectives:

After completing this activity, the learner will be able to:

Identify the consequences of major depression in later life and the importance of treatment.
Discuss the management of major depression in later life, including pharmacologic and nonpharmacologic treatments.
Describe the approaches to preventing depression.

Original Release Date: 02/01/2021

Review and Re-release Date: 03/01/2024

Expiration Date: 04/01/2025

Expert: Charles Reynolds, M.D.

Medical Editor: Lorena Rodriguez, M.D

Relevant Financial Disclosures:

None of the faculty, planners, and reviewers for this educational activity have relevant financial relationship(s) to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

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Credit Designation Statement

Medical Academy designates this enduring activity for a maximum of 1.25 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.