Cardiovascular Research

Gender differences in the assessment of depression in American Indian older adults: The Strong Heart Study.

Authors: Celestina Barbosa-Leiker|||Ekaterina Burduli|||Randi Arias-Losado|||Clemma Muller|||Carolyn Noonan|||Astrid Suchy-Dicey|||Lonnie Nelson|||Steven P Verney|||Thomas J Montine|||Dedra Buchwald

Affiliations: + Expand

Abstract

The validation of the assessment of depression across ethnic groups is critical yet deficient for American Indian (AI) adults. Therefore, we assessed the psychometric properties of the Center for Epidemiological Studies-Depression (CES-D) in AI elders and tested differences in depression constructs between gender. Participants were 817 AI adults (68% women), mean age 73.2 years ( = 6.1, range: 64-95) for women and 72.6 years ( = 5.3, range: 65-90) for men., in the Cerebrovascular Disease and Its Consequences in AIs Study. We evaluated the factor structure of the 20-item and 12-item CES-D and tested measurement invariance between gender. Results demonstrated a poor fit for the 20-item CES-D and partial gender measurement invariance of the 12-item CES-D. AI female elders had significantly higher depression levels than AI male elders on the Depressed Affect subscale, the Somatic Symptoms subscale, and the Well-Being (reverse-coded) subscale. Further replication is needed, and we recommend future psychometric work with the 12-item CES-D with AI elders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

---

Reference List

American Psychological Association Division of Diversity and Health Equity. (2017). Mental Health Disparities: American Indians and Alaska Natives.|||Andresen EM, Malmgren JA, Carter WB, & Patrick DL (1994). Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale). American Journal of Preventative Medicine, 10(2), 77–84.|||Barón AE, Manson SM, Ackerson LM, & Brenneman DL (1990). Depressive symptomatology in older American Indians with chronic disease: Some psychometric considerations. In Zich CCAJM (Ed.), Depression in primary care: Screening and detection (pp. 217–231). Florence, KY, US: Taylor & Frances/Routledge.|||Beals J, Novins DK, Whitesell NR, Spicer P, Mitchell CM, & Manson SM (2005). Prevalence of mental disorders and utilization of mental health services in two American Indian reservation populations: mental health disparities in a national context. American Journal of Psychiatry, 162(9), 1723–1732. doi: 10.1176/appi.ajp.162.9.1723|||Brown TA (2006). Confirmatory factor analysis for applied research. New York: Guilford Press.|||Centers for Disease Control and Prevention. (2014). Summary Health Statistics for U.S. Adults: National Health Interview Survey, 2012 RetrievedSeptember 19, 2019, from http://www.cdc.gov/nchs/data/series/sr_10/sr10_260.pdf|||Chapleski EE, Lamphere JK, Kaczynski R, Lichtenberg PA, & Dwyer JW (1997). Structure of a depression measure among American Indian elders: Confirmatory factor analysis of the CES-D scale. Research on Aging, 19(4), 462–485.|||Chen FF (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling-a Multidisciplinary Journal, 14(3), 464–504.|||Chen FF, Sousa KH, & West SG (2005). Testing measurement invariance of second-order factor models. Structural Equation Modeling-a Multidisciplinary Journal, 12(3), 471–492.|||Cheng ST, & Chan AC (2005). The Center for Epidemiologic Studies Depression Scale in older Chinese: thresholds for long and short forms. International Journal of Geriatric Psychiatry, 20(5), 465–470. doi: 10.1002/gps.1314|||Cole SR, Kawachi I, Maller SJ, & Berkman LF (2000). Test of item-response bias in the CES-D scale: experience from the New Haven EPESE Study. Journal of Clinical Epidemiology, 53(3), 285–289. doi: 10.1016/S0895-4356(99)00151-1|||Diniz BS, Butters MA, Albert SM, Dew MA, & Reynolds CF 3rd. (2013). Late-life depression and risk of vascular dementia and Alzheimer’s disease: systematic review and meta-analysis of community-based cohort studies. British Journal of Psychiatry, 202(5), 329–335. doi: 10.1192/bjp.bp.112.118307|||Gomez R, & McLaren S (2015). The Center for Epidemiological Studies Depression Scale: Measurement and structural invariance across ratings of older adult men and women. Personality and Individual Differences, 75, 130–134. doi: 10.1016/j.paid.2014.11.005|||Hackett ML, Yapa C, Parag V, & Anderson CS (2005). Frequency of depression after stroke: a systematic review of observational studies. Stroke, 36(6), 1330–1340.|||Heart MY, Chase J, Elkins J, & Altschul DB (2011). Historical trauma among Indigenous Peoples of the Americas: concepts, research, and clinical considerations. Journal of Psychoactive Drugss, 43(4), 282–290. doi: 10.1080/02791072.2011.628913|||Indian Health Services. (2018). Urban Indian Health Program, from https://www.ihs.gov/newsroom/factsheets/uihp/|||Kroenke K, Spitzer RL, & Williams JB (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. doi: 10.1046/j.1525-1497.2001.016009606.x|||Kuehner C (2003). Gender differences in unipolar depression: an update of epidemiological findings and possible explanations. Acta Psychiatrica Scandinavica 108(3), 163–174.|||Mohebbi M, Nguyen V, McNeil JJ, Woods RL, Nelson MR, Shah RC, … Group AI (2018). Psychometric properties of a short form of the Center for Epidemiologic Studies Depression (CES-D-10) scale for screening depressive symptoms in healthy community dwelling older adults. General Hospital Psychiatry, 51, 118–125. doi: 10.1016/j.genhosppsych.2017.08.002|||Musselman DL, Evans DL, & Nemeroff CB (1998). The relationship of depression to cardiovascular disease: epidemiology, biology, and treatment. Archives of General Psychiatry 55(7), 580–592. doi: 10.1001/archpsyc.55.7.580|||Muthén LK, & Muthén BO (1998–2018). Mplus User’s Guide (Eight Edition ed.). Los Angeles: Muthén & Muthén.|||Nemeroff CB, Musselman DL, & Evans DL (1998). Depression and cardiac disease. Depression and Anxiety, 8 Suppl 1, 71–79.|||Radloff LS (1977). The CES-D scale: A self report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.|||Schure M, & Goins RT (2017). Psychometric Examination of the Center for Epidemiologic Studies Depression Scale with Older American Indians: The Native Elder Care Study. American Indian and Alaska Native Mental Health Research, 24(3), 1–13. doi: 10.5820/Aian.2403.2017.1|||Somervell PD, Beals J, Kinzie JD, Boehnlein J, Leung P, & Manson SM (1992). Use of the Ces-D in an American-Indian Village. Culture Medicine and Psychiatry, 16(4), 503–517.|||Somervell PD, Beals J, Kinzie JD, Boehnlein J, Leung P, & Manson SM (1993). Criterion validity of the Center for Epidemiologic Studies Depression Scale in a population sample from an American Indian village. Psychiatry Research, 47(3), 255–266.|||Suchy-Dicey A, Verney SP, Nelson LA, Barbosa-Leiker C, Howard BA, Crane PK, & Buchwald DS (2020). Depression Symptoms and Cognitive Test Performance in Older American Indians: The Strong Heart Study. Journal of the American Geriatrics Society, doi: 10.1111/jgs.16434|||Suchy-Dicey AM, Shibata D, Best LG, Verney SP, Longstreth WT Jr., Lee ET, … Buchwald D (2016). Cranial Magnetic Resonance Imaging in Elderly American Indians: Design, Methods, and Implementation of the Cerebrovascular Disease and Its Consequences in American Indians Study. Neuroepidemiology, 47(2), 67–75. doi: 10.1159/000443277|||Zhang Y, Galloway JM, Welty TK, Wiebers DO, Whisnant JP, Devereux RB, … Yeh J (2008). Incidence and risk factors for stroke in American Indians. Circulation, 118(15), 1577–1584.