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Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: dimensionality and differential item functioning test.

ABSTRACT: BACKGROUND:Anxiety symptoms are pervasive among elderly populations around the world. The Geriatric Anxiety Inventory (the GAI) has been developed and widely used in screening those suffering from severe symptoms. Although debates about its dimensionality have been mostly resolved by Molde et al. (2019) with bifactor modeling, evidence regarding its measurement invariance across sex and somatic diseases is still missing. METHODS:This study attempted to provide complemental evidence to the dimensionality debates of the GAI with Mokken scale analysis and to examine its measurement invariance across sex and somatic diseases by conducting differential item functioning (DIF) analysis among a sample of older Chinese adults. The data was from responses of a large representative sample (N?=?1314) in the Chinese National Survey Data Archive, focusing on the mental health of elderly adults. RESULTS:The results of Mokken scale analysis confirmed the unidimensionality of the GAI, and DIF analysis indicated measurement invariance of this inventory across individuals with different sex and somatic diseases, with just a few items exhibiting item bias but all of them negligible. CONCLUSIONS:All these findings supported the use of this inventory among Chinese elders to screen anxiety symptoms and to make comparisons across sex and somatic diseases.

SUBMITTER: Li Z

PROVIDER: S-EPMC6858656 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: dimensionality and differential item functioning test.

Li Zhongquan Z Zhao Xia X Sheng Ang A Wang Li L

BMC geriatrics 20191115 1

<h4>Background</h4>Anxiety symptoms are pervasive among elderly populations around the world. The Geriatric Anxiety Inventory (the GAI) has been developed and widely used in screening those suffering from severe symptoms. Although debates about its dimensionality have been mostly resolved by Molde et al. (2019) with bifactor modeling, evidence regarding its measurement invariance across sex and somatic diseases is still missing.<h4>Methods</h4>This study attempted to provide complemental evidenc ...[more]

PMID: 31729965

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Project description:IntroductionThe outcomes anxiety and depression are measured frequently by healthcare providers to assess the impact of a disease, but with numerous instruments. PROMIS item banks provide an opportunity for standardized measurement. Cross-cultural validity of measures and the availability of reference values are prerequisites for standardized measurement.MethodsPROMIS Anxiety and Depression item banks were completed by 1002 representative Dutch persons. To evaluate cross-cultural validity, data from US participants in PROMIS wave 1 were used and differential item functioning (DIF) was investigated, using an iterative hybrid of logistic regression and item response theory. McFadden's pseudo R2-change of 2% was the critical threshold. The impact of any DIF on full item banks and short forms was investigated. To obtain Dutch reference values, T-scores for anxiety and depression were calculated for the complete Dutch sample, and age-group and gender subpopulations. Thresholds corresponding to normal limits, mild, moderate and severe symptoms were computed.ResultsIn both item banks, two items had DIF but with minimal impact on population level T-scores for full item banks and short forms. The Dutch general population had a T-score of 49.9 for anxiety and 49.6 for depression, similar to the T-scores of 50.0 of the US general population. T-scores for age-group and gender subpopulations were also similar to T-scores of the US general population. Thresholds for mild, moderate and severe anxiety and depression were set to 55, 60 and 70, identical to US thresholds.ConclusionsThe limited number of items with DIF and its minimal impact, enables the use of standard (US) item parameters and comparisons of scores between Dutch and US populations. The Dutch reference values provide an important tool for healthcare professionals and researchers to evaluate and interpret symptoms of anxiety and depression, stimulating the uptake of PROMIS measures, and contributing to standardized outcome measurement.

Dataset Information

Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: dimensionality and differential item functioning test.

Publications

Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: dimensionality and differential item functioning test.

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