Validation of the Whooley questions and the Beck Depression Inventory in older adults

Figures & data

Table I. General characteristics of the study group.¹

Characteristics	Total n = 474	Non-depressed^* n = 449 (94.7%)	Depressed^* n = 25 (5.3%)	p-value
Gender:				0.157
Male	197	190 (96.5)	7 (3.6)
Female	277	259 (93.5)	18 (6.5)
Marital status:				0.721
Married/cohabiting	322	308 (95.7)	14 (4.4)
Single	20	19 (95.0)	1 (5.0)
Widower/widow	112	105 (93.8)	7 (6.3)
Missing data	20
MMSE, mean (standard error)^†	26.6 (2.3)^†	26.6 (2.3)^†	27.0 (1.8)^†	0.485
Any chronic diseases:				0.965
No	37	35 (94.6)	2 (5.4)
Yes	420	398 (94.8)	22 (5.2)
Missing data	17

Notes: ¹Values are total numbers (percentages) of participants unless stated otherwise. ^*According to the MINI. ^†Mean (standard error).

Table II. Screening parameters of the BDI-21 for detecting major depression among the community sample of older adults (n = 474).

Cut-off point	Sensitivity, % (95% CI)	Specificity, % (95% CI)	Youden's index	LR+ (95% CI)	LR– (95% CI)
6	96.0 (79.6–99.9)	47.2 (42.5–52.0)	0.43	1.8 (1.6–2.1)	0.1 (0.01–0.6)
7	96.0 (79.6–99.9)	57.2 (52.5–61.9)	0.53	2.3 (2.0–2.6)	0.1 (0.01–0.5)
8	96.0 (79.6–99.9)	64.8 (60.2–69.2)	0.61	2.7 (2.4–3.2)	0.1 (0.01–0.4)
9	96.0 (79.6–99.9)	72.4 (68.0–76.5)	0.68	3.5 (2.9–4.1)	0.1 (0.01–0.4)
10	88.0 (68.8–97.5)	77.3 (73.1–81.1)	0.65	3.9 (3.1–4.9)	0.2 (0.05–0.5)
11	88.0 (68.8–97.5)	81.7 (77.8–85.2)	0.70	4.8 (3.8–6.2)	0.2 (0.05–0.4)
12	84.0 (63.9–95.5)	85.1 (81.4–88.2)	0.69	5.60 (4.3–7.4)	0.2 (0.1–0.5)
13	76.0 (54.9–90.6)	86.6 (83.1–89.6)	0.63	5.7 (4.1–7.9)	0.3 (0.1–0.6)
14	68.0 (46.5–85.1)	89.3 (86.1–92)	0.57	6.4 (4.4–9.3)	0.4 (0.2–0.6)
15	60.0 (38.7–78.9)	92.0 (89.1–94.3)	0.52	7.5 (4.8–11.7)	0.4 (0.3–0.7)
16	44.0 (24.4–65.1)	94.0 (91.4–96.0)	0.38	7.3 (4.1–13.0)	0.6 (0.4–0.8)
17	40.0 (21.1–61.3)	95.5 (93.2–97.3)	0.36	9.0 (4.7–17.1)	0.6 (0.5–0.9)
18	32.0 (14.9–53.5)	96.9 (94.8–98.3)	0.29	10.3 (4.8–22.2)	0.7 (0.5–0.9)
19	32.0 (14.9–53.5)	97.1 (95.1–98.4)	0.29	11.1 (5.1–24.2)	0.7 (0.5–0.9)
20	24.0 (9.4–45.1)	97.1 (95.1–98.4)	0.21	8.3 (3.4–20.0)	0.8 (0.6–1.0)
21	20.0 (6.8–40.7)	97.6 (95.7–98.8)	0.18	8.2 (3.1–21.7)	0.8 (0.7–1.0)

Figure 1. Receiver operating characteristic (ROC) curve of the BDI-21 for predicting major depression.

Table III. Screening parameters of the Whooley questions for detecting major depression among the community sample of older adults (n = 474).

Variable	Sensitivity, % (95% CI)	Specificity, % (95% CI)	LR+ (95% CI)	LR– (95% CI)
Either of the two screening questions alone	62.5 (40.6–81.2)	88.9 (85.6–91.7)	5.6 (3.7–8.5)	0.4 (0.2–0.7)
Help question alone	47.8 (26.8–69.4)	92.1 (89.2–94.5)	6.1 (3.4–10.7)	0.6 (0.5–0.7)
Either screening question plus the help question	66.7 (44.7–84.4)	85.9 (82.3–89.1)	4.7 (3.29–6.8)	0.4 (0.2–0.7)