Factorial validity of the Center for Epidemiologic Studies Depression Scale short form in older population in China

Background: The objective of this study was to explore the factor structure of a shortened ten-item Center for Epidemiologic Studies Depression Scale (CES-D 10) used in a national survey in China. Methods: This secondary research is based on the wave I (2011) of the China Health Aging Retirement and Longevity Study (CHARLS). CHARLS recruited a nationally representative community sample of households with members aged 45 years or above. A subsample of 742 respondents aged 60 years and older were used for this study. Confirmatory factor analyses were conducted to test three competing models and determine the best-fit model for the elderly Chinese sample. Factorial invariance across gender was also examined. R-2 coefficient was used to measure the reliability of each item. Results: Confirmatory factor analysis supported the two-factor model as having the best fit. Depressive affect and somatic symptoms were the first factor while positive affect was loaded as the second factor. The multi-group analysis showed that the two-factor structure varied across the male and female groups in China (chi(2) (df = 86) = 144.13, p < 0.001). Moreover, gender differences were indicated by individual item reliability scores, mean score, and prevalence rate of depressive symptoms. Conclusion: The CES-D 10 Scale indicated adequate reliability and validity for the community-dwelling older population in China. In addition, the data revealed that perception and expression of depressive feelings was different between male and female elderly people.