U Freudenstein1, A J Arthur, R J Matthews, C Jagger. 1. Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, UK. base@joanduli.freeserve.co.uk
Abstract
BACKGROUND: community surveys of depression among older people may be particularly prone to non-response. Information on non-responders is difficult to obtain and often limited to demographics. Therefore, the full extent of response bias is not always known. OBJECTIVE: to determine factors associated with non-response at each stage of a two-stage survey of late-life depression. SETTING: one large general practice (registered population >30000) serving the market town of Melton Mowbray, Leicestershire, UK. SUBJECTS: community residents (n=2633) aged 65-74 years registered with the practice. METHODS: a two-stage community survey of patients aged 65-74 years. The first stage was an interviewer-administered general health survey including a measure of depressive symptoms. We asked those who screened positive for possible depression to undergo a semi-structured psychiatric interview. We compared use of services and medication by non-responders and responders to both stages using primary-care records. We compared Townsend deprivation scores using data obtained from the 1991 census. RESULTS: responders to stage 1 were more likely to use both primary [odds ratio (OR) 1.65, 95% confidence interval (CI) 1.38-1.96] and secondary (OR 1.59, 95% CI 1.25-2.02) services and tended to live in more affluent areas (P=0.002). At stage 2, the only difference observed was a lower level of use of tranquillisers or hypnotics among responders (OR 0.27, 95% CI 0.11-0.67). CONCLUSIONS: older people with low levels of contact with health services may be under-represented in community surveys of depression. Investigators should look outside traditional health settings to promote the uptake of response in these studies.
BACKGROUND: community surveys of depression among older people may be particularly prone to non-response. Information on non-responders is difficult to obtain and often limited to demographics. Therefore, the full extent of response bias is not always known. OBJECTIVE: to determine factors associated with non-response at each stage of a two-stage survey of late-life depression. SETTING: one large general practice (registered population >30000) serving the market town of Melton Mowbray, Leicestershire, UK. SUBJECTS: community residents (n=2633) aged 65-74 years registered with the practice. METHODS: a two-stage community survey of patients aged 65-74 years. The first stage was an interviewer-administered general health survey including a measure of depressive symptoms. We asked those who screened positive for possible depression to undergo a semi-structured psychiatric interview. We compared use of services and medication by non-responders and responders to both stages using primary-care records. We compared Townsend deprivation scores using data obtained from the 1991 census. RESULTS: responders to stage 1 were more likely to use both primary [odds ratio (OR) 1.65, 95% confidence interval (CI) 1.38-1.96] and secondary (OR 1.59, 95% CI 1.25-2.02) services and tended to live in more affluent areas (P=0.002). At stage 2, the only difference observed was a lower level of use of tranquillisers or hypnotics among responders (OR 0.27, 95% CI 0.11-0.67). CONCLUSIONS: older people with low levels of contact with health services may be under-represented in community surveys of depression. Investigators should look outside traditional health settings to promote the uptake of response in these studies.
Authors: Pekka Jousilahti; Veikko Salomaa; Kari Kuulasmaa; Matti Niemelä; Erkki Vartiainen Journal: J Epidemiol Community Health Date: 2005-04 Impact factor: 3.710
Authors: Timothy S Wells; Isabel G Jacobson; Tyler C Smith; Christina N Spooner; Besa Smith; Robert J Reed; Paul J Amoroso; Margaret A K Ryan Journal: Eur J Epidemiol Date: 2008-01-10 Impact factor: 8.082
Authors: Lu Gao; Emma Green; Linda E Barnes; Carol Brayne; Fiona E Matthews; Louise Robinson; Antony Arthur Journal: Age Ageing Date: 2015-08-14 Impact factor: 10.668
Authors: Brian Williams; Linda Irvine; Alison R McGinnis; Marion E T McMurdo; Iain K Crombie Journal: BMC Health Serv Res Date: 2007-04-26 Impact factor: 2.655
Authors: Jaime L Horton; Isabel G Jacobson; Alyson J Littman; John E Alcaraz; Besa Smith; Nancy F Crum-Cianflone Journal: BMC Med Res Methodol Date: 2013-07-11 Impact factor: 4.615