Background
-
RQ 1: How feasible is an adapted version of a standardized diagnostic interview for the needs of people aged 65 and above in different European countries and Israel?
-
RQ 2: What are the psychometric properties of the adapted and translated standardized diagnostic interview?
-
RQ 3: What are the point, year and lifetime prevalence rates of mental and physical disorders among the older adult population of different European countries and Israel, and what is the relationship of this prevalence to symptom severity, activities and participation and service utilization?
Method
Design
Feasibility of the CIDI65+ (RQ 1)
Psychometric properties of the CIDI65+ (RQ 2)
Main prevalence study (RQ 3)
Sampling
Feasibility of the CIDI65+ (RQ 1)
Psychometric properties of the CIDI65+ (RQ 2)
Main prevalence study (RQ 3)
Measures
The Composite International Diagnostic Interview for older adults (CIDI65+)
The Health of the Nation Outcome Scales65+ (HoNOS65+)
The short version of the Big Five Inventory (BFI-10)
The World Health Organization QoL assessment (WHOQoL-BREF)
World Health Organization Disability Assessment Schedule II (WHODAS II)
Procedure (RQ 3)
Statistical analyses
Feasibility of the CIDI65+ (RQ 1)
Psychometric properties of the CIDI65+ (RQ 2)
Main prevalence study (RQ 3)
Results
Feasibility of the CIDI65+ (RQ 1)
Psychometric properties of the CIDI65+ (RQ 2)
Main prevalence study (RQ 3)
Sampling
Hamburg (Germany) | Ferrara (Italy) | London (England) | Madrid (Spain) | Geneva (Switzerland) | Jerusalem (Israel) | |
---|---|---|---|---|---|---|
Sample frame | Registries of resident registration offices in the metropolitan area of Hamburg through a market research company | Registries of resident registration offices in Ferrara and the province | Post office address files in Greenwich Borough and Canterbury District through a market research company | Addresses of residents in Madrid from the Statistical Institute of Madrid, a private company, and the Madrid City Council | Addresses of residents in the Geneva canton through a marketing company | Addresses of Jewish residents in the greater Jerusalem area through a market research company |
Stage 1 | Stratification by age and gender | Stratification by age and gender | Stratification by age and gender | Stratification by age and gender | Stratification by age, gender, socio-economic status, city/rural location | Stratification by age and gender |
Stage 2 | random selection from a registry of 5640 participants | random selection from registry - 1st selection: 2000 participants - 2nd selection: 1918 participants - 3rd selection: 720 participants | random selection from files - 1st selection: 2977 participants - 2nd selection: 1145 participants | random selection from a census of 1072 participants (Madrid administration) and 1063 from files (private company) | random selection from registry - 1st selection: 2000 participants - 2nd selection: 700 participants | random selection - 1st selection: 2500 participants - 2nd selection: 708 participants |
Hamburg (Germany) | Ferrara (Italy) | London (England) | Madrid (Spain) | Geneva (Switzerland) | Jerusalem (Israel) | |
---|---|---|---|---|---|---|
Total number of contacted people (N) | 5640 | 3213 | 2534 | 3375 | 2700 | 3208 |
Total number of people who agreed to participate (n, %) | 626 (11.1) | 546 (17.0) | 542 (21.4) | 584 (17.3) | 565 (20.9) | 609 (18.9) |
Excluded participants (n) | 13 | 23 | 10 | 3 | 4 | 60 |
Reasons for exclusion | cognitive problems | cognitive problems | cognitive problems | cognitive problems | cognitive problems | cognitive and language problems |
Drop out (not required)a
| 106 (54) | 0 | 36 | 26 | 41 | 7 |
Reasons for dropping out | Withdrawal of willingness to participate, illness, not reached, not required, invalid interview (incomplete data) | Denial or subsequent withdrawal of willingness to participate, illness, not reached, deceased, transferred, not required | Withdrawal of willingness to participate, illness, not reached, invalid interview (incomplete data) | Withdrawal of willingness to participate, not reached, illness, invalid interview (incomplete data) | Illness, holidays, difficulty locating, invalid interview (incomplete data) | Withdrawal of willingness to participate, illness |
Incentives | 25 Euro shopping voucher | A small gift | none | 15 Euro shopping voucher | None, except for a choice of interview location (home/office) | a small gift |
Final sample size (N) | 510 | 524 | 496 | 555 | 520 | 542 |
Response rate
Interview location and duration
Total sample n = 3142 | Hamburg (Germany)
n = 511 | Ferrara (Italy)
n = 518 | London (England)
n = 496 | Madrid (Spain)
n = 555 | Geneva (Switzerland)
n = 520 | Jerusalem (Israel)
n = 542 | P-value | ||
---|---|---|---|---|---|---|---|---|---|
Age: mean (SD) | 73.7 (5.6) | 73.7 (5.0) | 72.7 (5.3) | 74.4 (5.6) | 73.5 (6.0) | 73.2 (5.6) | 74.5 (5.6) | ||
Age categories: n (%) | 65–74 | 1715 (54.6) | 279 (54.6) | 343 (66.2) | 237 (47.8) | 296 (53.3) | 292 (56.2) | 268(49.4) | |
>75 | 1427 (45.4) | 232 (45.4) | 175 (33.8) | 259 (52.2) | 259 (46.7) | 228 (43.8) | 274 (50.6) | ||
Gender: n (%) | Female | 1592 (50.7) | 249 (48.7) | 233 (45.0) | 275 (55.4) | 288 (51.9) | 265 (51.0) | 282 (52.0) | |
Born in the country where the interview took place categories: n (%) | Yes | 2519 (80.2) | 473 (92.6) | 514 (99.2) | 473 (95.4) | 523 (94.2) | 336 (64.6) | 200 (36.9) | .001 |
Education: mean years of schooling (SD) | 10.3 (3.2) | 10.30 (2.0) | 8.9 (2.0) | 11.4 (1.7) | 8.0 (4.1) | 11.9 (1.9) | 11.4 (2.7) | .001 | |
Graduated from last school categories: n (%) | Yes | 2392 (77.2) | 485 (96.2) | 439 (88.7) | 342 (70.8) | 297 (53.5) | 433 (83.3) | 396 (73.2) | .001 |
Marital status categories: n (%) | Married | 1915 (61.0) | 314 (61.7) | 344 (66.5) | 301 (60.7) | 336 (60.5) | 304 (58.5) | 316 (58.3) | .003 |
Separated, Divorced Widowed | 1082 (34.5) | 178 (35.0) | 146 (28.2) | 166 (33.5) | 192 (34.6) | 186 (36.8) | 214 (39.5) | ||
Never married/other | 142 (4.5) | 17 (3.3) | 27 (5.2) | 29 (5.8) | 27 (4.9) | 30 (5.8) | 12 (2.2) | ||
Number of children: mean (SD) | 2.3 (1.5) | 1.9 (1.1) | 1.7 (0.9) | 2.3(1.4) | 2.5 (1.4) | 1.8 (1.2) | 3.4 (2.0) | .001 | |
Number of grandchildren: mean (SD) | 3.9 (5.8) | 2.4 (2.4) | 1.6 (1.6) | 3.8 (3.5) | 3.0 (3.1) | 2.6 (2.6) | 9.6 (10.8) | .001 | |
Number of household members: mean (SD) | 0.8 (0.7) | 0.7 (0.5) | 1.0 (0.7) | 0.8 (0.6) | 1.0 (0.8) | 0.8 (0.5) | 0.8 (0.7) | .001 | |
Number of close significants: mean (SD) | 11.7 (11.2) | 12.5 (10.9) | 3.6 (4.2) | 9.6 (9.2) | 10.4 (9.2) | 16.7(11.3) | 17.4 (13.6) | .001 | |
Employment status | Retired | 2640 (84.6) | 481 (94.9) | 457 (90.5) | 435 (88.4) | 400 (72.2) | 465 (89.4) | 402 (74.4) | .001 |
Working | 227 (7.3) | 14 (2.8) | 15 (3.0) | 45 (9.1) | 13 (2.3) | 50 (9.6) | 90 (16.7) | ||
Homemaker | 224 (7.2) | 10 (2.0) | 27 (5.3) | 5 (1.0) | 137 (24.7) | 5 (1.0) | 40 (7.4) | ||
Unemployed | 8 (0.3) | 0 | 1 (0.2) | 0 | 4 (0.7) | 0 | 3 (0.6) | ||
Other | 20 (0.6) | 2 (0.4) | 5 (1.0) | 7 (1.4) | 1 (0.2) | 0 | 5 (0.9) | ||
Self-rated socioeconomic status: mean (SD) | 6.2 (1.7) | 6.6 (1.5) | 5.8 (1.6) | 6.4 (1.4) | 5.5 (1.8) | 6.9 (1.6) | 6.1 (1.8) | ||
Self-rated financial situation categories: n (%) | Very good | 356 (11.4) | 66 (13.0) | 11 (2.1) | 68 (13.8) | 15 (2.7) | 122 (23.5) | 71 (13.8) | .001 |
Good | 1372 (43.8) | 241 (47.3) | 148 (28.8) | 254 (51.4) | 150 (27.0) | 335 (64.4) | 244 (45.4) | ||
Sufficient | 1145 (36.6) | 184 (36.1) | 303 (58.9) | 150 (30.4) | 291 (52.4) | 51 (9.8) | 166 (30.9) | ||
Poor | 219 (7.0) | 14 (2.8) | 44 (8.6) | 20 (4.0) | 86 (15.5) | 11 (2.1) | 44 (8.2) | ||
Very poor | 37 (1.2) | 4 (0.8) | 8 (1.6) | 2 (0.4) | 13 (2.3) | 1 (0.2) | 9 (1.7) | ||
Self-rated religious affiliation categories: n (%) | Very important | 827 (26.5) | 106 (20.8) | 199 (38.9) | 116 (23.5) | 186 (33.5) | 75 (14.5) | 145 (27.0) | .001 |
Somewhat important | 957 (30.6) | 179 (35.2) | 157 (30.7) | 151 (30.6) | 168 (30.3) | 126 (24.3) | 176 (32.7) | ||
Not very important | 660 (21.1) | 117 (23.0) | 85 (16.6) | 105 (21.3) | 127 (22.9) | 144 (27.7) | 82 (15.2) | ||
Not at all important | 682 (21.8) | 107 (21.0) | 70 (13.7) | 122 (24.7) | 74 (13.3) | 174 (22.5) | 135 (25.1) |
Socio-demographic characteristics of the MentDis_ICF65+ sample
Representativeness
Hamburg (Germany) | Ferrara (Italy) | London (England) | Madrid (Spain) | Geneva (Switzerland) | Jerusalem (Israel) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ment- Dis
n > 489 | Catchment
n > 447,780 | Ment-Dis
n > 516 | Catchment
n > 77,598 | Ment-Dis
n > 448 | Catch-ment
n > 55,474 | Ment-Dis
n > 554 | Catchment
n > 412,849 | Ment- Dis
n > 453 | Catchment
n > 15,110 | Ment-Dis
n > 540 | Catch-ment
n > 50,698 | ||||||
Work status: retired (%) | 94.5% | 90.6% | 88.4% | 95.8% | 88.4% | 84.3% | 72.1% | 52.4% | 89.4% | 93.1% | 74.4% | 81.7% | |||||
Marital status: married | 61.7% | 58.1% | 66.5% | 64.% | 60.8% | 65.5% | 60.5% | 59.8% | 58.5% | 53.8% | 58.5% | 53.8% | |||||
Number of children | none | No data | No data | No data | No data | No data | 5.0% | 6.4% | |||||||||
1 | 4.8% | 6.6% | |||||||||||||||
2 | 20.3% | 29.6% | |||||||||||||||
3 | 30.1% | 20.7% | |||||||||||||||
4 | 19.7% | 13.6% | |||||||||||||||
5 | 9.6% | 9.2% | |||||||||||||||
6 | 3.3% | 5.0% | |||||||||||||||
Education: years of schooling | – | 5 | 33.3% | 70.6% | No data | 7 | 40.5% | 59.9% | 7 | 3.5% | 17.6% | No data | |||||
– | 8 | 21.3% | 16.7% | 9 | 14.8% | 0% | 9 | 9.2% | 19.1% | ||||||||
10 | 67.% | 84.2% | 10 | 5.6% | 2.8% | – | – | ||||||||||
13 | 32.% | 15.8% | 13 | 39.7% | 9.9% | 13 | 44.6% | 40.1% | 13 | 87.3% | 63.2% | ||||||
Number of house-hold members | alone | 32.7% | 30.2% | No data | 32.8% | 79.5% | 24.2% | 21.6% | 25.6% | 50.6% | No data | ||||||
2 people | 65.3% | 60.9% | 67.2% | 20.5% | 54.2% | 47.2% | 68.4% | 33.1% | |||||||||
3 people | 2.0% | 8.9% | – | – | 18.1% | 21.7% | 6.0% | 16.3% | |||||||||
4 people | – | – | – | – | 3.2% | 9.5% | – | – | |||||||||
Born in the country where the interview took place | 92.7% | 85.5% | No data | 95.4% | 70.9% | 95.9% | 97.7% | 68.5% | 76.6% | 36.9% | 28.1% |
Hamburg (Germany) | Ferrara (Italy) | London (England) | Madrid (Spain) | Geneva (Switzerland) | Jerusalem (Israel) | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Ment-Dis sample
n > 499 | Country
n > 12,221,270 | Ment-Dis sample
n > 508 | Country
n > 2,300,636 | Ment-Dis sample n > 448 | Country
n > 637,979 | Ment-Dis sample
n > 513 | Country
n > 3,536,445 | Ment-Dis sample n > 453 | Country
n > 1,258,927 | Ment-Dis sample | Country | ||||||
Work status: retired (%) | 94.5% | 91.9% | 90.1% | 88.4% | 88.4% | 86.0% | 72.1% | 57.9% | 89.4% | 93% | No data | ||||||
Marital status: married | 61.7% | 41.0% | 66.5% | 63.1% | 60.8% | 63.5% | 60.5% | 59.7% | 58.5% | 57.6% | No data | ||||||
Number of children | No data | No data | No data | No data | No data | No data | |||||||||||
Education: years of schooling | 5 | 33.3% | 70.6% | No data | 7 | 40.5% | 69.% | 7 | 3.5% | 15.2% | No data | ||||||
8 | 21.3% | 16.7% | 9 | 14.8% | 0% | 9 | 9.2% | 19.0% | |||||||||
10 | 67.3% | 85.7% | 10 | 5.6% | 2.8% | – | – | – | – | – | – | ||||||
13 | 32.7% | 14.3% | 13 | 39.7% | 9.9% | 13 | 44.6% | 30.4% | 13 | 87.3% | 65.8% | ||||||
Number of household members | alone | 32.7% | 28.4% | 23.8% | 35.1% | 32.8% | 71.5% | 24.4% | 22.2% | 25.6% | 44.7% | No data | |||||
2 people | 65.3% | 61.6% | 60.6% | 46.6% | 67.2% | 28.5% | 54.2% | 47.3% | 68.4% | 39.3% | |||||||
3 people | 2.0% | 10.0% | 15.6% | 18.3% | – | – | 18.1% | 20.9% | 6.0% | 16.0% | |||||||
4 people | – | – | – | – | – | – | 3.2% | 9.5% | – | – | |||||||
Born in the country where the interview took place | 92.7% | 84.1% | 99.4% | 99.3% | 95.4% | 90.5% | 95.5% | 97.7% | 68.5% | 76.6% | No data |