Problems with the Japanese version of the Center for Epidemiologic Studies Depression (CES-D) scale when applied to Japanese independent community-dwelling elderly: an examination of the factor structure

ABSTRACT

<p><b>PURPOSE</b>The present study aimed to determine the problems of the Japanese version of the Center for Epidemiologic Studies Depression (CES-D) scale when applied to Japanese independent community-dwelling elderly focusing on its factor structure.</p><p><b>METHODS</b>The subjects were 1791 community-dwelling independent elderly aged 60 and over (848 males and 943 females). This study used the Japanese version of the CES-D scale to assess depression in the elderly.</p><p><b>RESULTS</b>From the results of an exploratory factor analysis, the four factors of somatic symptoms, depression affect, positive affect and relation with others were interpreted.These factors were the same as those in the previous study, but the items making up each subscale differed. Therefore, the construct validity of each subscale was not necessarily assured. In the confirmatory factor analysis, goodness-offit was high for both the first and second-order factor models. In examining the validity by Akaike's information criterion (AIC), the second-order factor model assuming depression as a higher-order factor among the four factors was a better fit than the first-order factor model. Although the reliability of each subscale was not sufficient, adequate reliability was assured in the total scale.</p><p><b>CONCLUSION</b>An assessment of depression using the Japanese version of the CES-D scale should be conducted using the total score, while a re-examination of items making up each subscale is needed.</p>