The clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes

Jeon, Yun-Hee, Li, Zhicheng, Low, Lee-Fay, Chenoweth, Lynn, O'Connor, Daniel, Beattie, Elizabeth, Liu, Zhixin, & Brodaty, Henry (2015) The clinical utility of the Cornell Scale for Depression in Dementia as a routine assessment in nursing homes. The American Journal of Geriatric Psychiatry, 23(8), pp. 784-793.

View at publisher

Abstract

Objective

To examine the clinical utility of the Cornell Scale for Depression in Dementia (CSDD) in nursing homes.

Setting

14 nursing homes in Sydney and Brisbane, Australia.

Participants

92 residents with a mean age of 85 years.

Measurements

Consenting residents were assessed by care staff for depression using the CSDD as part of their routine assessment. Specialist clinicians conducted assessment of depression using the Semi-structured Clinical Diagnostic Interview for DSM-IV-TR Axis I Disorders for residents without dementia or the Provisional Diagnostic Criteria for Depression in Alzheimer Disease for residents with dementia to establish expert clinical diagnoses of depression. The diagnostic performance of the staff completed CSDD was analyzed against expert diagnosis using receiver operating characteristic (ROC) curves.

Results

The CSDD showed low diagnostic accuracy, with areas under the ROC curve being 0.69, 0.68 and 0.70 for the total sample, residents with dementia and residents without dementia, respectively. At the standard CSDD cutoff score, the sensitivity and specificity were 71% and 59% for the total sample, 69% and 57% for residents with dementia, and 75% and 61% for residents without dementia. The Youden index (for optimizing cut-points) suggested different depression cutoff scores for residents with and without dementia.

Conclusion

When administered by nursing home staff the clinical utility of the CSDD is highly questionable in identifying depression. The complexity of the scale, the time required for collecting relevant information, and staff skills and knowledge of assessing depression in older people must be considered when using the CSDD in nursing homes.

Impact and interest:

6 citations in Scopus
5 citations in Web of Science®
Search Google Scholar™

Citation counts are sourced monthly from Scopus and Web of Science® citation databases.

These databases contain citations from different subsets of available publications and different time periods and thus the citation count from each is usually different. Some works are not in either database and no count is displayed. Scopus includes citations from articles published in 1996 onwards, and Web of Science® generally from 1980 onwards.

Citations counts from the Google Scholar™ indexing service can be viewed at the linked Google Scholar™ search.

ID Code: 79968
Item Type: Journal Article
Refereed: Yes
Keywords: depression, nursing homes, assessment, cornell scale for depression in dementia, dementia
DOI: 10.1016/j.jagp.2014.08.013
ISSN: 1064-7481
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Aged Care Nursing (111001)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000) > Mental Health Nursing (111005)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Residential Client Care (111718)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2014 American Association for Geriatric Psychiatry
Deposited On: 13 Jan 2015 23:14
Last Modified: 23 Jun 2017 16:01

Export: EndNote | Dublin Core | BibTeX

Repository Staff Only: item control page