Validation and Psychometric Properties of Behavioral Activation for Depression Scale in Older Adults

Objective This study aimed to adapt and validate the Behavioral Activation for Depression Scale in older adults of Korea (BADS-OK), and to verify its factor structure, internal consistency, convergent and construct validity, and incremental validity in predicting depression, loneliness, and suicidal ideation.Methods The cross-sectional study conducted questionnaire surveys and interviews. A total of 110 older adults (20 men and 90 women) participated in the first part, while 102 older adults (14 men and 88 women) participated in the second part. They are recruited form the community mental health centers managing high-risk older adults. The BADS, Valuing Questionnaire, Environmental Reward Observation Scale, Geriatric Depression Scale, Scale for Suicide Ideation, and University of California, Los Angeles Loneliness Scale were used.Results Exploratory factor analysis identified an 8-item, 4-factor structure (activation, avoidance/rumination, work/school impairment, and social impairment), which explained 85.2% of the variance and showed high internal consistency. Confirmatory factor analysis confirmed the validity of this structure. The BADS-OK significantly predicted depression, loneliness, and suicidal ideation, demonstrating high convergent and construct validity.Conclusion BADS-OK is a reliable and valid tool for assessing BA in older adults, enhancing psychometric understanding, and allowing for easier repeated assessments during BA sessions. Its applicability to the target population, including high-risk groups, and its potential to improve health and quality of life in the aging population, suggest that BADS-OK will be widely used in clinical and research settings.