Psychometric properties of a new short version of the State-Trait Anxiety Inventory (STAI) for the assessment of anxiety in the elderly

Introduction: Anxiety has negative effects on the cognitive performance and psychosocial adjustment of elderly people. Given the high prevalence of anxiety symptoms in patients suffering from cognitive impairment, it has been suggested that these symptoms may be an early marker of dementia. The State-Trait Anxiety Inventory (STAI) is one of the widely-used used scales for evaluating anxiety in elderly people. However, inasmuch as the STAI may be difficult to apply to older people, having a short form of it would be desirable. Methods: The participants comprised 489 community-dwelling individuals aged 68 years and over. All of them were volunteers in a longitudinal study for early detection of Alzheimer’ Disease (Proyecto Vallecas). The full sample was divided in two homogeneous subgroups: Group A, used to reduce the number of items and response options, and Group B, the group used to determine the psychometric properties of the new short form (STAIr). Results: A dichotomous Rasch model was used to obtain the STAIr. No statistically significant differences for STAIr scores were found with respect to sociodemographic variables. Psychometric properties and normative data were obtained for the new short-version. Conclusions: The STAIr is composed of 13 items and data fits the model well. Since it is short and easy to apply to elderly people, STAIr will be very useful in clinical and research settings. Resumen: Introducción: La ansiedad tiene efectos negativos sobre el rendimiento cognitivo y el ajuste psicosocial de las personas mayores. Dada la elevada prevalencia de los síntomas de ansiedad en personas con deterioro cognitivo, se ha indicado que podrían ser un marcador precoz de demencia. Una de las pruebas más utilizadas para valorar el nivel de ansiedad en personas mayores es el Inventario de Ansiedad Estado-Rasgo (STAI). No obstante, en la medida en que puede resultar una escala larga para los mayores, sería deseable contar con una versión abreviada de la misma. Métodos: Se reclutó una muestra de 489 participantes mayores de 68 años cognitivamente sanos, todos ellos eran voluntarios en un proyecto de investigación longitudinal sobre la enfermedad de Alzheimer (Proyecto Vallecas). La muestra se subdividió en 2 grupos homogéneos: el grupo A se utilizó para reducir el número de ítems y de opciones de respuesta, y el grupo B para obtener las propiedades psicométricas de la nueva escala reducida (STAIr). Resultados: Se empleó el modelo de Rasch dicotómico para obtener el STAIr. Las variables sociodemográficas no mostraron asociación con las puntuaciones de la nueva versión. Se estudiaron las propiedades psicométricas y se hallaron los datos normativos del STAIr. Conclusiones: La nueva versión STAIr se compone de 13 ítems y presenta una adecuada bondad psicométrica. En la medida en que es una escala rápida y sencilla para las personas mayores, su aplicación resulta útil en los contextos clínico e investigador. Keywords: Anxiety, Cognitive impairment, Ageing, Neuropsychological assessment, State-Trait Anxiety Inventory, Item response theory, Palabras clave: Ansiedad, Deterioro cognitivo, Envejecimiento, Evaluación neuropsicológica, Inventario de Ansiedad Estado-Rasgo, Teoría de respuesta al íte

Psychometric properties of the International Wellbeing Index in community-dwelling older adults

Background: This is the first study to analyze the psychometric properties of the International Wellbeing Index (IWI), which comprises the Personal Wellbeing Index (PWI) and National Wellbeing Index (NWI), among community-dwelling older adults.Methods: The IWI was applied to 1106 community-dwelling adults aged 60 years and over. The sample was additionally assessed using scales for comorbidity, disability, mood, general orientation to life, social support, health-related quality of life, and two questions assessing satisfaction with life as a whole and with life in Spain. The PWI and NWI were separately analyzed for acceptability, internal consistency, convergent and discriminative validity, and precision. Linear regression analyses of the PWI and the NWI were also conducted.Results: Mean scores were 71.0 ± 13.5 for the PWI and 49.5 ± 14.4 for the NWI. No floor or ceiling effects were detected. Cronbach's α was 0.88 for the PWI and 0.92 for the NWI. Factor analysis identified two factors in the IWI, and one factor in the PWI and NWI respectively. The PWI showed a correlation of 0.50 with the “satisfaction with life as a whole” item, and the NWI showed a correlation of 0.73 with the “satisfaction with life in Spain” item. There were significant differences in scores: in the PWI, according to gender, age, social support, education and depression; and in the NWI, according to education and depression. The regression model identified psychosocial, health and functional factors as determinants of the PWI (explained variance: 46.8%).Conclusions: The IWI displays good acceptability and is a consistent, valid and precise measure of global quality of life in older adults.Peer reviewe

MADRID+90 study on factors associated with longevity: Study design and preliminary data.

The progressive aging of the population represents a challenge for society. In particular, a strong increase in the number of people over 90 is expected in the next two decades. As this phenomenon will lead to an increase in illness and age-related dependency, the study of long-lived people represents an opportunity to explore which lifestyle factors are associated with healthy aging and which with the emergence of age-related diseases, especially Alzheimer's type dementia. The project "Factors associated with healthy and pathologically aging in a sample of elderly people over 90 in the city of Madrid" (MADRID+90) brings together a multidisciplinary research team in neurodegenerative diseases that includes experts in epidemiology, neurology, neuropsychology, neuroimaging and computational neuroscience. In the first phase of the project, a stratified random sampling was carried out according to the census of the city of Madrid followed by a survey conducted on 191 people aged 90 and over. This survey gathered information on demographics, clinical data, lifestyles and cognitive status. Here, the main results of that survey are showed. The second phase of the project aims to characterize individual trajectories in the course of either healthy and pathological aging, from a group of 50 subjects over 90 who will undergo a comprehensive clinical examination comprised of neurological and cognitive testing, MRI and EEG. The ultimate goal of the project is to characterize the biophysical and clinical profiles of a population that tends to receive little attention in the literature. A better understanding of the rapidly increasing group of nonagenarians will also help to design new policies that minimize the impact and future social and economic consequences of rapidly aging societies