Demographic characteristics do not decrease the utility of depressive symptoms assessments: Examining the practical impact of item bias in four heterogeneous samples of older adults

Natalia O. Dmitrieva, Denise Fyffe, Shubhabrata Mukherjee, Robert Fieo, Laura B. Zahodne, Jamie Hamilton, Guy G. Potter, Jennifer J. Manly, Heather R. Romero, Dan M Mungas, Laura E. Gibbons

Research output: Contribution to journalArticle

3 Scopus citations


Objective: Previous studies have identified differential item function (DIF) in depressive symptoms measures, but the impact of DIF has been rarely reported. Given the critical importance of depressive symptoms assessment among older adults, we examined whether DIF due to demographic characteristics resulted in salient score changes in commonly used measures. Methods: Four longitudinal studies of cognitive aging provided a sample size of 3754 older adults and included individuals both with and without a clinical diagnosis of major depression. Each study administered at least one of the following measures: the Center for Epidemiologic Studies Depression scale (20-item ordinal response or 10-item dichotomous response versions), the Geriatric Depression Scale, and the Montgomery-Åsberg Depression Rating Scale. Hybrid logistic regression-item response theory methods were used to examine the presence and impact of DIF due to age, sex, race/ethnicity, and years of education on the depressive symptoms items. Results: Although statistically significant DIF due to demographic factors was present on several items, its cumulative impact on depressive symptoms scores was practically negligible. Conclusions: The findings support substantive meaningfulness of previously reported demographic differences in depressive symptoms among older adults, showing that these individual differences were unlikely to have resulted from item bias attributable to demographic characteristics we examined.

Original languageEnglish (US)
Pages (from-to)88-96
Number of pages9
JournalInternational Journal of Geriatric Psychiatry
Issue number1
StatePublished - Jan 1 2015



  • CES-D
  • Depressive symptoms
  • Differential item function
  • GDS
  • Item bias

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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