Dimensionality and differential item endorsement of depressive symptoms among aging Black populations in South Africa: Findings from the HAALSI study
| dc.contributor.author | Leslie B | |
| dc.contributor.author | Adams a b | |
| dc.contributor.author | Meagan Farrell a | |
| dc.contributor.author | Sumaya Mall c | |
| dc.contributor.author | Nomsa Mahlalela d | |
| dc.contributor.author | Lisa Berkman a | |
| dc.date.accessioned | 2023-08-17T08:24:11Z | |
| dc.date.available | 2023-08-17T08:24:11Z | |
| dc.date.issued | 2020-09-02 | |
| dc.department | SA-MRC/Wits Agincourt Unit | E |
| dc.description | We used baseline data from the Health and Aging in Africa: A Longitudinal Study of an INDEPTH Community in South Africa (HAALSI) cohort. HAALSI is the first Health and Retirement Study (HRS) sister study in Africa, and is conducted in the Mpumalanga region of South Africa (Gómez-Olivé et al., 2018). HAALSI was created to establish a population-based longitudinal cohort of men and women aged 40 and over in a rural South African community (Gómez-Olivé et al., 2018). The cohort included 5059 | |
| dc.description.abstract | Background The Center for Epidemiologic Studies-Depression (CES-D) scale is a widely used measure of depressive symptoms, but its construct validity has not been adequately assessed in sub-Saharan Africa. This study validates the CES-D among an aging Shangaan-speaking and predominantly Black African sample in rural South Africa, with a special emphasis on gender differences. Methods An 8-item CES-D scale was administered in Shangaan to 5059 respondents, aged 40+ years, residing in Agincourt, South Africa. We used Cronbach's alpha and exploratory and confirmatory factor analysis to examine and confirm dimensionality of the CES-D scale. Differential endorsement of CES-D items by gender were assessed using the Mantel-Haenszel (MH) odds ratio test. Results Reliability of the CES-D scale differed by gender with women reporting higher internal consistency on items than men. A two-factor solution was retained and confirmed representing two latent factors: (1) Negative Affect (six items) and (2) Diminished Positive Affect (two items). MH results showed that men exhibited significantly higher odds of putting an effort in everything that they did (OR: 1.33, 95% CI: 1.15–1.54) and lower odds of feeling depressed (OR: 0.71, 95% CI: 0.56–0.89) and having restless sleep (OR: 0.67, 95% CI:0.58–0.77) than women. Limitations Analyses were limited to a dichotomous, short form of the CES-D, a self-reported population-based measure. Conclusion Aging Black Africans differ in endorsing affective and somatic items on the CES-D scale by gender, which may lead to skewed population-level estimates of depression in key subpopulations. These findings highlight the importance of continued research disentangling cross-cultural and gendered nuances of depression measurements. | |
| dc.description.librarian | PM2023 | |
| dc.description.sponsorship | The HAALSI study, funded by the National Institute on Aging (P01 AG041710), is nested within the Agincourt Health and Socio-Demographic Surveillance System site, supported by the University of the Witwatersrand and Medical Research Council, South Africa, and the Wellcome Trust, UK (grants 058893/Z/99/A; 069683/Z/02/Z; 085477/Z/08/Z; 085477/B/08/Z). LBA is supported by the NIH Loan Repayment Award (NIMHD L60MD014539). SM is supported by an early career research award from the Claude Leon | |
| dc.identifier.uri | https://hdl.handle.net/10539/35812 | |
| dc.language.iso | en | |
| dc.school | Public Health | E |
| dc.title | Dimensionality and differential item endorsement of depressive symptoms among aging Black populations in South Africa: Findings from the HAALSI study |