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Validity of the SF‐36 Five‐Item Mental Health Index for Major Depression in Functionally Impaired, Community‐Dwelling Elderly Patients
Author(s) -
Friedman Bruce,
Heisel Marnin,
Delavan Rachel
Publication year - 2005
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2005.00469.x
Subject(s) - cronbach's alpha , medicine , construct validity , criterion validity , correlation , depression (economics) , mental health , geriatric depression scale , observational study , gerontology , clinical psychology , psychometrics , psychiatry , cognition , depressive symptoms , geometry , mathematics , economics , macroeconomics
Objectives: To examine criterion and construct validity of the five‐item Mental Health Index (MHI‐5) of the 36‐item Short Form health survey (SF‐36) in relation to the presence of major depression in functionally impaired, community‐dwelling elderly patients and of eight subsamples defined by cognitive functioning, levels of functional impairment, and proxy report versus self‐report. Design: Cross‐sectional observational. Setting: Nineteen counties in western New York, West Virginia, and Ohio. Participants: One thousand four hundred forty‐four functionally impaired, community‐dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Primary and Consumer‐Directed Care Demonstration. Measurements: MHI‐5, Mini‐International Neuropsychiatric Interview Major Depressive Episode (MINI‐MDE) module. Results: The MHI‐5 demonstrated sufficient criterion validity (area under the receiver operating characteristic curve=0.837; sensitivity=78.7% and specificity=72.1% using a cutpoint of 59/60) with respect to the presence of depression for the entire sample. A significant correlation between MHI‐5 scores and presence of major depression as identified using the MINI‐MDE (Spearman correlation=−0.426, P <.001), a strong correlation between the MHI‐5 and the SF‐36 role emotional scale (Spearman correlation=0.522) and a weak correlation with the SF‐36 physical functioning scale (Spearman correlation=0.133) provided evidence for construct validity. Additional evidence is provided by decline in mean MHI‐5 score as level of formal education and number of close friends and relatives decreased. All eight subsamples demonstrated similar criterion and construct validity. A Cronbach alpha of 0.794 demonstrated internal consistency reliability. Conclusion: This study provides evidence for adequate criterion and construct validity of the MHI‐5 in relation to the presence of major depression among functionally impaired, community‐dwelling elderly Medicare patients.