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Validating a single-question depression measure among older adults.

Kyung-Duk Min1, Heeran Chun2, Il-Ho Kim3

  • 1Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea.

International Psychogeriatrics
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A single-question depression screening tool significantly underestimates depression prevalence in older adults. Its accuracy varies by education level, highlighting the need for caution in community studies.

Keywords:
accuracycomposite indexdepression measuresingle question

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Area of Science:

  • Geriatric psychiatry
  • Public health research
  • Mental health assessment

Background:

  • Single-item depression measures are widely used in community studies.
  • Their adequacy in capturing complex mental health issues is questionable.
  • This study compares a single-item measure against established scales (CES-D, GDS).

Purpose of the Study:

  • To evaluate the accuracy of a single-question depression measure.
  • To compare its performance with the Center for Epidemiologic Studies Depression Scale (CES-D) and the Geriatric Depression Scale (GDS).
  • To identify demographic factors influencing the measure's accuracy.

Main Methods:

  • 800 elderly participants (60-89 years) in Seoul were surveyed in 2015.
  • Trained interviewers administered a questionnaire.
  • Accuracy was assessed using Kappa index, sensitivity, specificity, PPV, NPV, and AUC.

Main Results:

  • Single-item measure showed much lower prevalence (5.5%) vs. CES-D (12.3%) and GDS (12.1%).
  • Sensitivity was low (30.6% vs. CES-D, 36.1% vs. GDS).
  • Significant educational disparities in accuracy were observed, with higher education linked to better sensitivity.

Conclusions:

  • A single-question depression measure should be used with caution.
  • It may substantially underestimate depression in older adults.
  • Educational background impacts the reliability of single-item depression screening.