Validation of the Whooley questions and the Beck Depression Inventory in older adults |
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| Authors: | Kadri Suija Ulla Rajala Jari Jokelainen Timo Liukkonen Pirjo H?rk?nen Sirkka Kein?nen-Kiukaanniemi Markku Timonen |
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| Affiliation: | 1.Department of Family Medicine, University of Tartu, Estonia;2.Institute of Health Sciences (General Practice), University of Oulu, Finland;3.Unit of General Practice, Oulu University Hospital, Finland;4.Savonlinna Central Hospital, Finland;5.Oulu Deaconess Institute, Department of Sport Medicine, Finland;6.Oulu Health Centre, Finland |
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| Abstract: | ObjectiveTo analyse the psychometric properties of the Whooley questions and the 21-item Beck Depression Inventory (BDI-21) in older adults with depression and chronic health problems.DesignA population-based study.SettingCommunity.Subjects474 adults, aged 72–73 years, living in the city of Oulu, Finland.Main outcome measuresThe screening parameters of the Whooley questions and the BDI-21 for detecting major depression.ResultsThe prevalence of major depression according to the DSM-IV was 5.3% (single or recurrent episode) obtained by the Mini Neuropsychiatric Interview (MINI). The BDI-21 was best able to identify a current episode of major depression with a cut-off point of 11. The sensitivity and specificity of this cut-off point were 88.0% (95% confidence interval (95% CI) 68.8–97.5) and 81.7% (95% CI 77.8–85.2), respectively. The area under the receiver operating characteristics (ROC) curve was 0.89 (95% CI 0.83–0.96). The two Whooley screening questions had a sensitivity of 62.5% (95% CI 40.6–81.2) and either screening question plus the help question had a sensitivity of 66.7% (44.7–84.4).ConclusionsThe Beck Depression Inventory is a valid instrument for the diagnosis of depression in older adults. As a screening measure, the optimal cut-off score should be 11 or higher. Our results indicate that the sensitivity of the Whooley questions is not high enough to be used as a screening scale among the elderly.Key Words: Depression, elderly, Finland, general practice, screening instruments, validation studiesCurrent guidelines recommend use of screening tests in patient populations where the prevalence of depression is high, such as older adults or patients with chronic physical illnesses.- Based on our results, the Beck Depression Inventory is a valid instrument for the diagnosis of depression among older adults. As a screening measure, the optimal cut-off score would be 11 or higher. The sensitivity of the Whooley questions seems not to be high enough to use it as a screening scale among elderly.
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