Validation of the Spanish version of the EURO‐D scale: an instrument for detecting depression in older people

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Abstract
Objective To standardize the EURO‐D scale as a method for detecting depression in Spanish older people. Methods In a first phase, a sample of 1080 community older people was assessed with the GMS‐AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non‐cases were assessed using DSM‐III‐R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test–retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated. Results A high internal consistency was obtained in both phases of the study (α = 0.75; α = 0.79, respectively). Test–retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM‐III‐R diagnosis validity coefficients (cut‐off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89–0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale. Conclusions The EURO‐D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results. Copyright © 2006 John Wiley & Sons, Ltd.