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

Abstract

BackgroundAnxiety 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.MethodsThis 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.ResultsThe 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.ConclusionsAll these findings supported the use of this inventory among Chinese elders to screen anxiety symptoms and to make comparisons across sex and somatic diseases.

A Mokken scale analysis of the Kessler-6 screening measure among Chinese older population: findings from a national survey

“…Traditionally, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) are used in examining the factor structure of the K6 [ 11 , 21 ]. Mokken scale analysis (MSA) has demonstrated its unique value in addressing the problem of dimensionality [ 24 – 26 ]. It belongs to the family of nonparametric item response theories.…”

Anxiety in Later Life and Across the Lifespan

“…Note that these examples of anxiety symptom variation across the lifespan – and item comparisons across countries – were undertaken with samples from higher-income countries. A remaining gap concerns data from middle- and lower-income countries, although work in this area is gaining momentum (e.g., Li et al, 2019; Shati et al, 2021). First Nations people are another group beginning to have attention paid to assessing their anxiety and depression in later life (Russell et al., 2023).…”

A Mokken Scale Analysis of the Kessler-6 Screening Measure among Chinese Older Population: Findings from a national survey

“…Traditionally, exploratory factor analysis (EFA) and con rmatory factor analysis (CFA) are used in examining the factor structure of the K6 [11,21]. Mokken scale analysis (MSA) has demonstrated its unique value in addressing the problem of dimensionality [24][25][26]. It belongs to the family of nonparametric item response theories.…”