The outcome was 12-, 24- and 36-month mortality following HF surgery. DDs diagnoses were based on current antidepressant treatment and Geriatric Depression Scale (GDS-15) scores (scores ≥ 5 indicate significant depressive symptoms) [24 ]. In addition, fluctuations of clinical state were observed and registered by the Organic Brain Syndrome scale (OBS scale) [25 (link)]. The GDS-15 has good sensitivity and specificity, even among very old people with low Mini Mental State Examination (MMSE) scores, for DDs detection according to the Diagnostic and Statistical Manual of Mental Disorders – Text revision (4.th ed.; DSM-IV-TR) [26 (link), 27 (link)]. Cognitive function was assessed using the MMSE, (scores 0–30, scores ≤ 23 indicate significant cognitive impairment) [28 ].
At the end of the RCTs, a consultant geriatrician (YG), blinded to group allocation and not employed at the wards, set all diagnoses. The consultant geriatrician used all possible information from patient’s medical record (diagnoses, complications, and other important documentations), patient’s prescribed drugs and assessments performed in these RCTs (including the MMSE, GDS- 15, Philadelphia Geriatric Center Morale Scale (PGCMS) [29 , 30 (link)], Katz ADL index, OBS Scale), as well as vision and hearing tests, to determine whether participants fulfilled the DMS-IV-TR criteria for DDs and dementia.
At the end of the RCTs, a consultant geriatrician (YG), blinded to group allocation and not employed at the wards, set all diagnoses. The consultant geriatrician used all possible information from patient’s medical record (diagnoses, complications, and other important documentations), patient’s prescribed drugs and assessments performed in these RCTs (including the MMSE, GDS- 15, Philadelphia Geriatric Center Morale Scale (PGCMS) [29 , 30 (link)], Katz ADL index, OBS Scale), as well as vision and hearing tests, to determine whether participants fulfilled the DMS-IV-TR criteria for DDs and dementia.
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