Factor structure and psychometric properties of the center for epidemiologic studies depression scale (CES-D) in older populations with and without cognitive impairment.

The CES-D is widely used for the assessment of depressive symptoms in the adult population. However, few studies have been performed to assess the utility of this scale in an older population with cognitive impairment. The factor structure of the Spanish version of the CES-D was examined in an observational, cross sectional study in 623 older adults (M = 72.74 years; SD = 7.7). The validity of the scale was determined in two samples of older adults, one comprising 162 participants with cognitive impairment (M = 76.73 years; SD = 8.1) and one with 58 participants without cognitive impairment (M = 74.64 years; SD = 9.0). The results confirm previous results of a four factor structure. With regard to the validity of the scale, in the group with cognitive impairment the area under the ROC curve is 0.84 (95% CI: 0.77-0.89) and the cut-off point for possible depression is 13, while in the group without cognitive impairment the area is 0.90 (95% CI: 0.79-0.96) and the optimal cut-off point is 28. These results show that the Spanish version of the CES-D is a valid instrument for the identification of depression in older adults with and without cognitive impairment.