title: Nijmegen observer-rated depression scale for detection of depression in nursing home residents.
abstract: OBJECTIVE
  This study aims to test the accuracy of the Nijmegen observer-rated depression (NORD) scale, a new short scale for screening of depression in nursing home (NH) residents with and without dementia.
  
  
  METHODS
  This cross-sectional study with 103 residents with dementia (N = 19 depressed) and 72 residents without dementia (N = 10 depressed) was undertaken in 13 Dutch NH units. An elderly care physician and a psychologist of each unit assessed residents for the presence of clinical depression. Primary professional caregivers administered the NORD scale.
  
  
  RESULTS
  Five of the six proposed items showed acceptable performance in screening for depression. Receiver operating characteristic analyses revealed significant areas under the empirical curve (AUC) for the 5-item NORD scale in the total sample (AUC = 0.83, p < 0.001), as well as in residents with dementia (AUC = 0.84, p < 0.001) and without dementia (AUC = 0.84, p < 0.001). The cutoff score of >1 showed the highest sum of sensitivity (100) and specificity (69) in non-dementia and >2 the highest sum of sensitivity (79) and specificity (77) in dementia. The cutoff score of >1 showed the lowest negative likelihood ratio of 0.0 in non-dementia and of 0.2 in dementia. The highest positive likelihood ratios were found for the cutoff of >2 in non-dementia (3.4) and for >4 in dementia (26.5).
  
  
  CONCLUSIONS
  The 5-item NORD scale showed acceptable accuracy comparable with those of more extensive scales in other studies. It is easy and quick to administer and can be used for screening of depression in NH residents with or without dementia.
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands. R.Leontjevas@elg.umcn.nl
authors.forename: Ruslan
authors.initials: R
authors.lastname: Leontjevas
authors.forename: Debby L
authors.initials: DL
authors.lastname: Gerritsen
authors.forename: Myrra J F J
authors.initials: MJ
authors.lastname: Vernooij-Dassen
authors.forename: Steven
authors.initials: S
authors.lastname: Teerenstra
authors.forename: Martin
authors.initials: M
authors.lastname: Smalbrugge
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D003704:Dementia / Q000523:psychology*; D003866:Depressive Disorder / Q000175:diagnosis*; D005260:Female; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009735:Nursing Homes; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D012372:ROC Curve; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity