Age and Ageing 2001; 30: 517-521
© 2001, British Geriatrics Society
Research papers |
Community surveys of late-life depression: who are the non-responders?
Department of Epidemiology and Public Health, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK
Abstract
Background: community surveys of depression among older people may be particularly prone to non-response. Information on non-responders is difficult to obtain and often limited to demographics. Therefore, the full extent of response bias is not always known.
Objective: to determine factors associated with non-response at each stage of a two-stage survey of late-life depression.
Setting: one large general practice (registered population >30000) serving the market town of Melton Mowbray, Leicestershire, UK.
Subjects: community residents (n=2633) aged 65–74 years registered with the practice.
Methods: a two-stage community survey of patients aged 65–74 years. The first stage was an interviewer-administered general health survey including a measure of depressive symptoms. We asked those who screened positive for possible depression to undergo a semi-structured psychiatric interview. We compared use of services and medication by non-responders and responders to both stages using primary-care records. We compared Townsend deprivation scores using data obtained from the 1991 census.
Results: responders to stage 1 were more likely to use both primary [odds ratio (OR) 1.65, 95% confidence interval (CI) 1.38–1.96] and secondary (OR 1.59, 95% CI 1.25–2.02) services and tended to live in more affluent areas (P=0.002). At stage 2, the only difference observed was a lower level of use of tranquillisers or hypnotics among responders (OR 0.27, 95% CI 0.11–0.67).
Conclusions: older people with low levels of contact with health services may be under-represented in community surveys of depression. Investigators should look outside traditional health settings to promote the uptake of response in these studies.
Keywords: aged, depression, response bias
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