Jiangbo Ying1, Philip Yap2,3, Mihir Gandhi4,5, Tau Ming Liew6,7. 1. Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore. 2. Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore. 3. Geriatric Education and Research Institute, Singapore, Singapore. 4. Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore. 5. Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore. 6. Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore, tau_ming_liew@imh.com.sg. 7. Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore, tau_ming_liew@imh.com.sg.
Abstract
BACKGROUND/AIMS: The psychometric properties of Center for Epidemiological Studies Depression Scale (CES-D) have never been substantively investigated in caregivers of persons with dementia (PwD). We evaluated the validity and reliability of CES-D for detecting caregiver depression in dementia, and assessed whether CES-D could provide added utility beyond Zarit Burden Interview (ZBI). METHOD: Family caregivers of community-dwelling PwD (n = 394) completed self-administered questionnaires containing CES-D. Factorial validity was evaluated with confirmatory factor analysis; convergent and discriminant validity with Pearson's correlation coefficient; known-group validity by comparing across key variables; and internal consistency reliability with Cronbach's α. Cohen's κ was used to compare the agreement between those with depression (CES-D ≥16) and those with high caregiver burden (ZBI >60). RESULTS: CES-D demonstrated convergent, discriminant and known-group validity, consistent with a priori hypotheses. The original four-factor model of CES-D produced the best model-fit indices. Internal consistency reliability was good for the CES-D total scale (α = 0.92), but lower for the Positive affect and Interpersonal problems subscales (α = 0.70-0.74). Forty-five percent of the caregivers had depression as identified by CES-D (95% CI 40-50%), but most of them were not identified by high ZBI scores (κ = 0.16). CONCLUSIONS: CES-D is a valid and reliable scale for detecting caregiver depression in dementia. It has added utility, beyond that of a caregiver burden scale, in identifying a subgroup of caregivers with depression but not burden. However, two subscales (Positive affect and Interpersonal problems) may require caution in interpretation among non-Caucasian caregivers. The Author(s). Published by S. Karger AG, Basel.
BACKGROUND/AIMS: The psychometric properties of Center for Epidemiological Studies Depression Scale (CES-D) have never been substantively investigated in caregivers of persons with dementia (PwD). We evaluated the validity and reliability of CES-D for detecting caregiver depression in dementia, and assessed whether CES-D could provide added utility beyond Zarit Burden Interview (ZBI). METHOD: Family caregivers of community-dwelling PwD (n = 394) completed self-administered questionnaires containing CES-D. Factorial validity was evaluated with confirmatory factor analysis; convergent and discriminant validity with Pearson's correlation coefficient; known-group validity by comparing across key variables; and internal consistency reliability with Cronbach's α. Cohen's κ was used to compare the agreement between those with depression (CES-D ≥16) and those with high caregiver burden (ZBI >60). RESULTS: CES-D demonstrated convergent, discriminant and known-group validity, consistent with a priori hypotheses. The original four-factor model of CES-D produced the best model-fit indices. Internal consistency reliability was good for the CES-D total scale (α = 0.92), but lower for the Positive affect and Interpersonal problems subscales (α = 0.70-0.74). Forty-five percent of the caregivers had depression as identified by CES-D (95% CI 40-50%), but most of them were not identified by high ZBI scores (κ = 0.16). CONCLUSIONS: CES-D is a valid and reliable scale for detecting caregiver depression in dementia. It has added utility, beyond that of a caregiver burden scale, in identifying a subgroup of caregivers with depression but not burden. However, two subscales (Positive affect and Interpersonal problems) may require caution in interpretation among non-Caucasian caregivers. The Author(s). Published by S. Karger AG, Basel.
Authors: Julie T Bidwell; Camelia E Hostinar; Melinda K Higgins; Martha A Abshire; Fawn Cothran; Brittany Butts; Andrew H Miller; Elizabeth Corwin; Sandra B Dunbar Journal: Psychoneuroendocrinology Date: 2021-08-28 Impact factor: 4.905
Authors: Dana M Alhasan; Jana A Hirsch; Chandra L Jackson; Maggi C Miller; Bo Cai; Matthew C Lohman Journal: Int J Environ Res Public Health Date: 2021-01-21 Impact factor: 3.390