Validity of the SF-36 Five-Item Mental Health Index for Major Depression in Functionally Impaired, Community-Dwelling Elderly Patients

Objectives: To examine criterion and construct validity of the five‐item Mental Health Index (MHI‐5) of the 36‐item Short Form health survey (SF‐36) in relation to the presence of major depression in functionally impaired, community‐dwelling elderly patients and of eight subsamples defined by cognitive functioning, levels of functional impairment, and proxy report versus self‐report. Design: Cross‐sectional observational. Setting: Nineteen counties in western New York, West Virginia, and Ohio. Participants: One thousand four hundred forty‐four functionally impaired, community‐dwelling Medicare beneficiaries aged 65 and older who participated in the Medicare Primary and Consumer‐Directed Care Demonstration. Measurements: MHI‐5, Mini‐International Neuropsychiatric Interview Major Depressive Episode (MINI‐MDE) module. Results: The MHI‐5 demonstrated sufficient criterion validity (area under the receiver operating characteristic curve=0.837; sensitivity=78.7% and specificity=72.1% using a cutpoint of 59/60) with respect to the presence of depression for the entire sample. A significant correlation between MHI‐5 scores and presence of major depression as identified using the MINI‐MDE (Spearman correlation=−0.426, P