Community surveys of late-life depression: who are the non-responders?
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.


METHODS
one large general practice (registered population >30000) serving the market town of Melton Mowbray, Leicestershire, UK.


METHODS
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.
Freudenstein
U
U
Department of Epidemiology and Public Health, University of Leicester, 22-28 Princess Road West, Leicester LE1 6TP, UK. base@joanduli.freeserve.co.uk
Arthur
A J
AJ
Matthews
R J
RJ
Jagger
C
C
D000368:Aged; D003153:Community Health Services / Q000706:statistics & numerical data*; D003863:Depression; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data*; D005852:Geriatric Psychiatry; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology / Q000706:statistics & numerical data*