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J Affect Disord. 2015 Sep 15;184:129-36. doi: 10.1016/j.jad.2015.05.053. Epub 2015 Jun 10.

A multiple indicators multiple causes model of late-life depression in Latin American countries.

Author information

1
Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. Electronic address: brailean.anamaria@gmail.com.
2
Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Institute of Memory, Depression and Disease Risk, Avda Constructores 1230, Lima 12, Peru; Peruvian University, Cayetano, Heredia, Lima, Peru.
3
Department of Health Service and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Abstract

BACKGROUND:

The Euro-D depression scale consists of symptom clusters that may be differentially related to demographic and cognitive characteristics in older adults. This hypothesis needs further investigation and the role of measurement bias on substantive conclusions remains to be established.

METHOD:

The study sample comprised 10,405 community-dwelling older adults from six Latin American countries. We applied a Multiple Indicators Multiple Causes (MIMIC) model for a concurrent investigation of measurement bias and of the association between Euro-D symptom clusters and background variables.

RESULTS:

The factorial validity of Euro-D, with a two-dimensional structure--affective suffering and motivation disturbance, was consistently supported in all countries. Although complete measurement invariance could not be assumed across countries, measurement bias was minor. Both Euro-D factors were unrelated to age, but related to gender, as well as to impairment in memory and verbal fluency. Gender differences were larger for affective suffering than for motivation disturbance, whereas differences in verbal fluency impairment were more strongly related to motivation disturbance.

LIMITATIONS:

Our analytic strategies could only examine invariance at the level of indicator thresholds. The generalisability of current findings needs to be examined in clinical populations. A wider set of cognitive tests is needed. We did not examine the compositional factors that could have accounted for the variation in Euro-D scores across countries, as this was beyond the aims of the paper.

CONCLUSION:

The current study adds evidence for the construct validity of Euro-D and for the possible differential association of depression symptom-clusters with gender and verbal fluency in older adults. An understanding of the heterogeneity of late-life depression may carry clinical implications for the diagnosis and treatment of depression in old age.

KEYWORDS:

Cognitive function; Depression; Measurement invariance; Multiple indicators multiple causes model; Older adults

PMID:
26092097
PMCID:
PMC4533237
DOI:
10.1016/j.jad.2015.05.053
[Indexed for MEDLINE]
Free PMC Article

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