Regular Research ArticlesComparative Validation of Proxy-Based Montgomery-Åsberg Depression Rating Scale and Cornell Scale for Depression in Dementia in Nursing Home Residents With Dementia
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Participants and Design
The sample for the present cross-sectional study was drawn from a larger, ongoing effectiveness study of the multidisciplinary care program, “Act in Case of Depression” (AID) study, aimed to identify and treat depression in NH residents.26 All data reflect baseline and preintervention assessments. The residents were recruited from seven of the 16 cluster-randomized dementia special care units participating in the AID study. Inclusion criteria were written consent by the legal representative on
RESULTS
Of the 117 residents recruited for the current study, 16 residents died or moved to another unit before they could be assessed. The study sample consisted of 28 male (27.7%) and 73 female residents (Table 1). Of the 101 residents from seven care units (8–22 residents per unit), 18 (17, 8%) were diagnosed as depressed. Dementia type, as specified in personal file, was as follows (first diagnosis N [n depressed]): Alzheimer's disease N = 25 (6), vascular dementia N = 24 (1), other type N = 7 (2),
DISCUSSION
With regard to the first aim of this study, both MADRS and CSDD performed moderately in distinguishing depressed from nondepressed NH residents with dementia when only one source of information was available, namely that of professional caregivers. The ROC analyses revealed that the scales did not significantly differ in their performance against the diagnostic criteria for depression in dementia. Although concurrent validity was acceptable, both the MADRS and CSDD had a combination of a high
CONCLUSIONS
The fact that interviewing the resident was not possible in at least half of our sample underlines the need for the validation of proxy-based depression scales. The results of our study showed that the CSDD and MADRS may be used for screening purposes in NH residents with dementia when only one source of information is available, namely professional caregivers. In addition, it was demonstrated that different imputation methods for missing items might lead to different optimal cutoff scores,
References (40)
- et al.
Depression in Alzheimer's disease: overview and treatment
Biol Psychiatry
(2002) - et al.
A 12 months follow-up study of depression among nursing-home patients in Norway
J Affect Disord
(2010) - et al.
The Montgomery-Asberg depression rating scale and the Cornell scale for depression in dementia: a validation study with patients exhibiting early-onset dementia
Am J Geriatr Psychiatry
(2009) - et al.
Cornell scale for depression in dementia
Biol Psychiatry
(1988) - et al.
A psychometric evaluation of the Cornell Scale for Depression in Dementia in a frail, nursing home population
Am J Geriatr Psychiatry
(2002) - et al.
Provisional diagnostic criteria for depression of Alzheimer disease: rationale and background
Am J Geriatr Psychiatry
(2002) - et al.
Provisional diagnostic criteria for depression of Alzheimer disease
Am J Geriatr Psychiatry
(2002) - et al.
Tests for the evaluation of depression in the elderly: a systematic review
Arch Gerontol Geriatr
(2010) - et al.
Comparison of different clinical diagnostic criteria for depression in Alzheimer disease
Am J Geriatr Psychiatry
(2006) - et al.
Comorbid depression in dementia on psychogeriatric nursing home wards: which symptoms are prominent?
Am J Geriatr Psychiatry
(2009)
Antidepressant Use in Geriatric Populations: The Burden of Side Effects and Interactions and Their Impact on Adherence and Costs
Am J Geriatr Psychiatry
Psychosocial treatments of psychological symptoms in dementia: a systematic review of reports meeting quality standards
Int Psychogeriatr
Characteristics associated with depression in long-term care residents with dementia
Gerontologist
Recognising depression in residential facilities: an Australian challenge
Int J Geriatr Psychiatry
Distinguishing between depression and dementia in older persons: Neuropsychological and neuropathological correlates
J Geriatr Psychiatry Neurol
Determinants of quality of life in nursing home residents with dementia
Dement Geriatr Cogn Disord
Quality of life in dementia patients in long-term care
Int J Geriatr Psychiatry
The impact of depression and anxiety on well-being, disability and use of health care services in nursing home patients
Int J Geriatr Psychiatry
Cognitive decline in patients with dementia as a function of depression
Am J Geriatr Psychiatry
Mortality in Alzheimer's disease: a comparative prospective Korean study in the community and nursing homes
Int J Geriatr Psychiatry
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The authors thank the research assistant, Alexandra Evers, M.Sc.; the AID-study team; and all of the nursing home personnel who contributed to the study.
The authors declare no conflicts of interest.
This study was supported by The Netherlands Organization for Health Research and Development (ZonMW), contract/grant number: 170992801.