The Beck Depression Inventory-II in Community-Dwelling Middle-Aged and Older Greeks: Factor Structure and Demographic Associations

Evaluating depressive symptomatology in older adults is important for monitoring and treatment. However, few studies have examined the association of the Beck Depression Inventory-II (BDI-II) to demographic characteristics in middle-aged and older adults or have tested its factor structure using confirmatory factor analysis (CFA). Participants were 542 middle-aged and older Greek community-dwellers of a wide education range. The BDI-II score was correlated with age and education and one-way analysis of variance compared mean score in men and women, controlling for differences in education. In addition to the unidimensional model, eight models were tested using CFA: four two-factor models, a three-factor model, two bifactor models, and a hierarchical model with three first order factors and a second order factor. Age was marginally associated with BDI-II score; education was inversely associated with it in this sample of a wide range of education. Women scored higher than men, although controlling for education attenuated the differences. Internal consistency was similar to that of other studies. Of the nine models tested using CFA eight showed good fit but the bifactor models yielded anomalous factor loadings. The hierarchical model of Byrne, Stewart, Kennard, and Lee showed the best fit in terms of all the indices. The results indicate the presence of a second-order general depression factor that influences highly correlated first-order factors and extend the applicability of the hierarchical model to older community dwellers.