title: Validation of the Spanish version of the EURO-D scale: an instrument for detecting depression in older people.
abstract: OBJECTIVE
  To standardize the EURO-D scale as a method for detecting depression in Spanish older people.
  
  
  METHODS
  In a first phase, a sample of 1080 community older people was assessed with the GMS-AGECAT by lay interviewers. In a second phase, all the probable cases and a similar number of randomly selected probable non-cases were assessed using DSM-III-R diagnosis by psychiatrists. To test reliability, internal consistency with the Cronbach alpha coefficient and test-retest reliability (Kappa value) were obtained. Validity, sensitivity and specificity, predictive values, Receiver Operating Characteristic (ROC) curve, and Specific Likelihood Ratios (SSLR) were calculated.
  
  
  RESULTS
  A high internal consistency was obtained in both phases of the study (alpha = 0.75; alpha = 0.79, respectively). Test-retest reliability was acceptable (weighted kappa = 0.60). For the prediction of DSM-III-R diagnosis validity coefficients (cut-off point 3/4) were: sensitivity 91.8%, specificity 76.6% and area under the ROC curve 0.92 [95% Confidence Intervals (0.89-0.95)]. Illiteracy and cognitive difficulties had a small negative effect on the performance of the scale.
  
  
  CONCLUSIONS
  The EURO-D scale is a reliable and valid instrument for detecting probable cases of depression in older people in Spain. Illiteracy and cognitive difficulties should be considered when interpreting the results.
authors.affiliation: Universidad de Zaragoza and Hospital Clínico Universitario, Zaragoza, Spain.
authors.forename: Laura
authors.initials: L
authors.lastname: Larraga
authors.forename: Pedro
authors.initials: P
authors.lastname: Saz
authors.forename: Michael E
authors.initials: ME
authors.lastname: Dewey
authors.forename: Guillermo
authors.initials: G
authors.lastname: Marcos
authors.forename: Antonio
authors.initials: A
authors.lastname: Lobo
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003866:Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology