Screening for depressive symptoms among older adults in Taiwan: Cutoff of a short form of the Center for Epidemiologic Studies Depression Scale

Screening for elders at risk for depression is crucial for promoting mental health in later life. The present study investigates the cutoff score of a short form of the CES-D for screening of depressive symptoms in the elderly population of Taiwan. This particular short form of CES-D is repeatedly used in the Taiwan Longitudinal Study on Aging (TLSA), a national survey of representative older adults in Taiwan, and is therefore referred to as the TLSA form. Data collected from five waves of TLSA were analyzed in this study. Participant responses repeatedly measured in 1989 and 1993 were used to identify a cutoff for the TLSA form of the CES-D with sensitivity and specificity using the cutoff of 4 on the Boston form of the CES-D as the criterion. Longitudinal data from the years 1996, 1999, and 2003 were used to validate the proposed cutoff by comparing the prevalence rates for depressive symptoms among older Taiwanese estimated from the identified cutoff and reported in previous studies. The score of 10 on the TLSA form of the CES-D was suggested, yielding a specificity of 0.93 and a sensitivity of approximately 0.96. The estimated prevalence rates for depressive symptoms among Taiwanese elders based on the suggested cutoff were between 18.9% and 23.7%, which are similar to previously reported rates. The cutoff score of 10 on the TLSA form of the CES-D is therefore recommended for screening depressive symptoms among older adults in Taiwan.