ArticleThe American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry2025
Development and Validation of the DA3 Scale for Assessing Depression, Anxiety, and Apathy in Older Adults.
Article in The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
objectivesTo validate the Depression, Anxiety, and Apathy (DA3) scale for assessing symptoms of depression, anxiety, and apathy in community-dwelling mid- and late-life adults with and without cognitive impairment.
designCross-sectional psychometric validation study.
settingCommunity-based longitudinal study of brain health.
participantsA total of 252 participants (mean age, 68.8 ± 9.4 years; 68.5% women; 71.3% non-Hispanic White; 66.8% cognitively normal) completed the study. MEASUREMENTS: The DA3 scale was compared with established measures of mood including the Hospital Anxiety and Depression Scale (HADS), Apathy Scale (AS), Generalized Anxiety Disorder-7 (GAD7), Patient Health Questionnaire-8 (PHQ8), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Psychometric properties were assessed using reliability and validity measures, confirmatory factor analysis (CFA), and Mokken scale analysis.
resultsThe DA3 demonstrated strong internal consistency (Cronbach's alpha, 0.670-0.781). CFA supported a three-factor model corresponding to distinct depression, anxiety, and apathy dimensions, with excellent goodness-of-fit. Mokken analysis confirmed acceptable-to-strong scalability (H coefficients, 0.36-0.54). The DA3 subscales demonstrated strong convergent validity with established measures (e.g., HADS, AS, GAD-7, and PHQ-8). Cut-off scores of five on each subscale achieved optimal agreement with gold standard measures. Performance of the DA3 was consistent across sociodemographic, neuropsychological, and cognitive subgroups.
conclusionsThe DA3 is a unitary, brief, valid, and reliable tool for assessing depression, anxiety, and apathy in community-dwelling older adults, including those with cognitive impairment. Its strong psychometric properties support its use in both clinical and research settings. Future studies should examine its longitudinal utility to better understand its role in tracking mood symptoms over time.
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