Older adults requiring home care service have a high risk of depression. Instruments for detecting depression among older adults, however, are often too long and detailed for easy administration by nontrained staff in large service-based settings.This study examined the measurement properties (test—retest reliability, concurrent validity, and cross-modality correspondence) of a single-item screener for depressive symptoms among older adults receiving home care services. Reliability was assessed (n = 65) by administering the single-item depression screener to the same participants on two occasions 7 days apart. Validity was assessed (n = 191) by comparing depressed participants from the single-item depression screener versus Geriatric Depression Scale (criterion measure). Responses to the single-item depression screener administered by telephone and face-to-face interview were also compared. Findings suggest that the single-item depression screener has fair levels of reliability, validity, and cross-modality correspondence and could be used among home care recipients as a screening tool, provided that depression status is confirmed via in-depth questionnaires, interviews, or a clinical diagnosis.
Almeida, O.P., & Almeida, S.A. ( 1999). Short versions of the Geriatric Depression Scale: A study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. International Journal of Geriatric Psychiatry , 14, 858-865.
2.
Andrews, G., Henderson, S., & Hall, W. ( 2001). Prevalence, comorbidity, disability and service utilisation . British Journal of Psychiatry, 178, 145-153.
3.
Arthur, A., Jagger, C., Lindesay, J., Graham, C., & Clarke, M. ( 1999). Using an annual over-75 health check to screen for depression: Validation of the short Geriatric Depression Scale (GDS15) within general practice. International Journal of Geriatric Psychiatry, 14, 431-439.
4.
Banerjee, S. ( 1993). Prevalence and recognition of psychiatric disorder in the elderly clients of a community care service. International Journal of Geriatric Psychiatry, 8, 125-131.
5.
Banerjee, S., Shamash, K., Macdonald, A., & Mann, A. ( 1998). The use of the SelfCARE(D) as a screening tool for depression in the clients of local authority home care services-a preliminary study. International Journal of Geriatric Psychiatry, 13, 695-699.
6.
Borson, S., Bartels, S., Colenda, C., Gottlieb, G., & Meyers, B. ( 2001). Geriatric mental health services research: Strategic plan for an aging population: Report of the Health Services Work Group of the American Association for Geriatric Psychiatry. American Journal of Geriatric Psychiatry, 9, 191-204.
7.
Brown, E.L., Bruce, M.L., McAvay, G.J., Raue, P.J., Lachs, M.S., & Nassisi, P. ( 2004). Recognition of late life depression in home care: Accuracy of the Outcome and Assessment Information Set. Journal of the American Geriatrics Society, 52, 995-999.
8.
Bruce, M. ( 2002). Mental health services in home healthcare: Opportunities and challenges. Generations, 26(1), 78-82.
9.
Bruce, M., McAvay, G., Raue, P., Brown, E., Meyers, B., Keohane, D., et al. (2002). Major depression in elderly home health care patients. American Journal of Psychiatry, 159, 1367-1374.
10.
Bula, C., Wietlisbach, V., Bertrand, Y., & Burnand, B. ( 2003). Does a single item question identify elderly medical inpatients who report significant depressive symptoms? Age and Ageing, 32, 231-233.
11.
Bula, C., Wietlishach, V., Burnand, B., & Yersin, B. ( 2001). Depressive symptoms as a predictor of 6-month outcomes and services utilization in elderly medical inpatients. Archives of Internal Medicine, 161, 2609-2615.
12.
Burke, W., Roccaforte, W., Wengel, S., Conley, D., & Potter, J. ( 1995). The reliability and validity of the Geriatric Depression Rating Scale administered by telephone. Journal of the American Geriatrics Society, 43, 674-679.
13.
Carrete, P., Augustovski, F., Gimpel, N., Fernandez, S., Di Paolo, R., Schaffer, I., et al. (2001). Validation of a telephone-administered Geriatric Depression Scale in a Hispanic elderly population. Journal of General Internal Medicine, 16, 446-450.
14.
Chochinov, H.M., Wilson, K.G., Enns, M., & Lander, S. ( 1997). "Are you depressed?" Screening for depression in the terminally ill. American Journal of Psychiatry, 154, 674-676.
15.
Corson, K., Gerrity, M., & Dobscha, S. ( 2004). Screening for depression and suicidality in a VA primary care setting: 2 items are better than 1 item. American Journal of Managed Care, 10, 839-845.
16.
D’Ath, P., Katona, P., Mullan, E., Evans, S., & Katona, C. ( 1994). Screening, detection and management of depression in elderly primary care attenders: The acceptability and performance of the 15 item Geriatric Depression Scale (GDS15) and the development of shorter versions . Family Practice, 11, 260-266.
17.
Davidson, H., Feldman, P., & Crawford, S. ( 1994). Measuring depressive symptoms in the frail elderly. Journal of Gerontology, 49, 159-164.
18.
Feinson, M.C. ( 1989). Are psychological disorders most prevalent among older adults? Examining the evidence. Social Science & Medicine , 29, 1175-1181.
19.
Folstein, M.F., Folstein, S.E., & McHugh, P.R. (1975). "Mini-mental state." A practical method for grading the cognitive state of patients for the clinician . Journal of Psychiatric Research, 12, 189-198.
20.
Fortes, C., Farchi, S., Forastiere, F.,Agabiti, N., Pacifici, R., Zuccaro, P., et al. (2003). Depressive symptoms lead to impaired cellular immune response. Psychotherapy and Psychosomatics, 72, 253-260.
21.
Gallo, J., & Rabins, P. ( 1999). Depression without sadness: Alternative presentations of depression in late life. American Family Physician, 60, 820-826.
22.
Gori, C., Appollonio, I., Riva, G.P., Spiga, D., Ferrari, A., Trabucchi, M., et al. (1998). Using a single question to screen for depression in the nursing home. Archives of Gerontology and Geriatrics , 26(Suppl. 6), 235-240.
23.
Kane, R.L. ( 2005). Understanding health care outcomes research (2nd ed.): Sudbury, MA: Jones & Bartlett.
24.
Katona, C., Livingston, G., Manela, M., Leek, C., Mullan, E., Orrell, M., et al. (1997). The symptomatology of depression in the elderly. International Clinical Psychopharmacology, 12, S19-S23.
25.
Lachs, M.S., Feinstein, A.R., Cooney, L.M., Drickamer, M.A., Margaret, A., Marottoli, R.A., et al. (1980). A simple procedure for general screening for functional disability in elderly patients. Annals of Internal Medicine, 112, 699-706.
26.
Landis, J.R., & Koch, G.G. ( 1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159-174.
27.
Lewin, G., & Calver, J. ( 2004). Older Australian home care clients who screen positive for depression. Australasian Journal on Ageing, 25, 84-88.
28.
Lowe, B., Kroenke, K., & Grafe, K. ( 2005). Detecting and monitoring depression with a two-item questionnaire (PHQ-2). Journal of Psychosomatic Research, 58, 163-171.
29.
Luber, M., Hollenberg, J., Williams-Russo, P., DiDomenico, T., Meyers, B., Alexopoulos, G., et al. (2000). Diagnosis, treatment, comorbidity, and resource utilisation of patients in a general medical practice. International Journal of Psychiatric Medicine, 30, 1-13.
30.
MacClure, M., & Willett, M. ( 1987). Misinterpretation and misuse of the kappa statistic. American Journal of Epidemiology, 6, 161-169.
31.
Madeley, P., & Wattis, J. ( 1994). Education in old age psychiatry. International Review of Psychiatry, 6, 119-125.
32.
Mahoney, J., Drinka, T., Abler, R., Gunter-Hunt, G., Matthews, C., Gravenstein, S., et al. (1994). Screening for depression: Single question versus GDS. Journal of the American Geriatrics Society, 42, 1006-1008.
33.
McAvay, G., Bruce, M., Raue, P., & Brown, E. ( 2004). Depression in elderly home care patients: Patient versus informant reports. Psychological Medicine, 34, 1507-1517.
34.
Meeks, S., Murrell, S., & Mehl, R. ( 2000). Longitudinal relationship between depressive symptoms and health in normal older and middle-aged adults. Psychological Aging, 15, 100-109.
35.
Moore, A., & Siu, A. ( 1996). Screening for common problems in ambulatory elderly: Clinical confirmation of a screening instrument. American Journal of Medicine, 100, 438-443.
36.
Nunnally, J. ( 1978). Psychometric theory (2nd ed.). New York: McGraw Hill.
37.
Osborn, D., Fletcher, A., Smeeth, L., Stirling, S., Bulpitt, C., Nunes, M., et al. (2003). Performance of a single screening question for depression in a representative sample of 13670 people aged 75 and over in the UK: results from the MRC trial of assessment and management of older people in the community. Family Practice, 20, 682-684.
38.
Pomeroy, I., Clark, C., & Philp, I. ( 2001). The effectiveness of very short scales for depression screening in elderly medical patients. International Journal of Geriatric Psychiatry, 16, 321-326.
39.
Rinaldi, P., Mecocci, P., Benedetti, C., Ercolani, S., Bregnocchi, M., Menculini, G., et al. (2003). Validation of the five-item Geriatric Depression Scale in elderly subjects in three different settings. Journal of the American Geriatrics Society, 51, 694-698.
40.
Setareh, W., Stanislav, V., Heiat, A., Abramson, J., Krumholz, H., & Vaccarino, V. ( 2002). Depression and risk of heart failure among the elderly: A prospective community-based study. Psychosomatic Medicine , 64, 6-12.
41.
Shapiro, A., & Taylor, M. ( 2002). Effects of a community-based early intervention program on the subjective well-being, institutionalization, and mortality of low-income elders. The Gerontologist, 42, 334-341.
42.
Sheikh, J., & Yesavage, J. ( 1986). Geriatric Depression Scale: Recent evidence of a shorter version. The Clinical Gerontologist, 5, 165-173.
43.
Weeks, S., McGann, P., Michaels, T., & Penninx, B. ( 2003). Comparing various short-form Geriatric Depression Scales leads to the GDS-5/15. Journal of Nursing Scholarship, 35, 133-137.
44.
Wittchen, H.U., Hofler, M., & Meister, W. ( 2001). Prevalence and recognition of depressive syndromes in German primary care settings: Poorly recognized and treated? International Clinical Psychopharmacology, 16, 121-135.
45.
Yesavage, J., Brink, T., Rose, T., Lum, O., Huang, V., Adey, M., et al. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
