Comparative Validation of Proxy-Based Montgomery-Åsberg Depression Rating Scale and Cornell Scale for Depression in Dementia in Nursing Home Residents With Dementia

R. Leontjevas*, Debby L. Gerritsen, Myrra J.F.J. Vernooij-Dassen , Martin Smalbrugge, Raymond T.C.M. Koopmans

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    26 Citations (Web of Science)

    Abstract

    OBJECTIVE: To 1) compare the accuracy of the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Cornell Scale for Depression in Dementia (CSDD) in nursing home residents with dementia when professional caregivers are the only available source of information and 2) explore different methods to account for missing items.

    DESIGN: Cross-sectional design.

    SETTING: Nursing home (NH).

    PARTICIPANTS: One hundred one residents with dementia.

    MEASUREMENTS: NH residents with dementia were assessed on the presence of clinical depression using Provisional Diagnostic Criteria for Depression of Alzheimer's Disease. The MADRS and CSDD were administered in a structured interview with professional primary caregivers.

    RESULTS: Receiver operating characteristic analyses revealed no significant differences between areas under the empirical curve for MADRS and CSDD. Imputation of a lowest possible item score for missing items revealed larger areas than three other methods (significant result only for CSDD). A MADRS cutoff score of ">13" yielded the highest sum of sensitivity (78%) and specificity (66%). A CSDD cutoff score of ">6" yielded the highest sum of sensitivity (94%) and specificity (49%). Both scales showed high negative predictive values up to 100% and low positive predictive values not exceeding 50%.

    CONCLUSION: The proxy-based MADRS and CSDD did not differ in distinguishing depressed from nondepressed NH residents and may be used for screening purposes. For missing items, imputation of a lowest possib le item score may be applied. The MADRS and CSDD may be better used for ruling out rather than for ruling in depression.
    Original languageEnglish
    Pages (from-to)985–993
    Number of pages9
    JournalAmerican Journal of Geriatric Psychiatry
    Volume20
    Issue number11
    DOIs
    Publication statusPublished - Nov 2012

    Keywords

    • Dementia
    • depression assessment
    • nursing home
    • validation
    • Aged
    • Aged, 80 and over
    • Alzheimer Disease/diagnosis
    • Cross-Sectional Studies
    • Humans
    • Male
    • Mass Screening
    • Nursing Homes
    • Personality Assessment/statistics & numerical data
    • Psychometrics/statistics & numerical data
    • Reproducibility of Results

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