title: Comparative validation of proxy-based Montgomery-Åsberg depression rating scale and cornell scale for depression in dementia in nursing home residents with dementia.
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.
  
  
  METHODS
  Cross-sectional design.
  
  
  METHODS
  Nursing home (NH).
  
  
  METHODS
  One hundred one residents with dementia.
  
  
  METHODS
  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%.
  
  
  CONCLUSIONS
  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.
authors: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen, P.O. Box 9101, Code 117 ELG, 6500 HB Nijmegen, the Netherlands. R.Leontjevas@elg.umcn.nl
authors: Ruslan
authors: R
authors: Leontjevas
authors: Debby L
authors: DL
authors: Gerritsen
authors: Myrra J F J
authors: MJ
authors: Vernooij-Dassen
authors: Martin
authors: M
authors: Smalbrugge
authors: Raymond T C M
authors: RT
authors: Koopmans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008403:Mass Screening; D009735:Nursing Homes; D010552:Personality Assessment / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results