Validity of the SF‐36 Five‐Item Mental Health Index for Major Depression in Functionally Impaired, Community‐Dwelling Elderly Patients

Marnin J. Heisel · Rachel L. Delavan

142 citations0/0 files storedJournal of the American Geriatrics Society

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Health Systems, Economic Evaluations, Quality of Life Aging, Health, and Disability Health and Well-being Studies

Abstract

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.

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References

1992The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection.2003SF-36 health survey: Manual and interpretation guide 1993The MOS 36-Item Short-Form Health Survey (SF-36)1998The mini international neuropsychiatric interview 1988The MOS Short-form General Health Survey 1997The validity of the Mini International Neuropsychiatric Interview (MINI) according to the SCID-P and its reliability 1991Performance of a Five-Item Mental Health Screening Test 2003Measuring the mental health status of the Norwegian population: A comparison of the instruments SCL-25, SCL-10, SCL-5 and MHI-5 (SF-36)

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