Cornell Scale for Depression in Dementia

Abstract

The Cornell Scale for Depression in Dementia (CSDD) was specifically developed to assess signs and symptoms of major depression in patients with dementia. Because some of these patients may give unreliable reports, the CSDD uses a comprehensive interviewing approach that derives information from the patient and the informant. Information is elicited through two semi-structured interviews; an interview with an informant and an interview with the patient. Based on these interviews, the interviewer can score the CSDD by assigning a preliminary score to each item of the scale on the basis of the informant's report in the "Informant" column. The next step is for the rater to interview the patient using the Cornell scale items as a guide. The interviews focus on depressive symptoms and signs occurring during the week preceding the interview. Many of the items during the patient interview can be filled after direct observation of the patient. If there are discrepancies in ratings generated from the informant and the patient interviews, the rater should re-interview both the informant and the patient to resolve the discrepancies. The final ratings of the CSDD items represent the rater's clinical impression rather than the responses of the informant or the patient. The CSDD takes approximately 20 minutes to administer. Each item is rated for severity on a scale of 0-2 (0=absent, 1=mild or intermittent, 2=severe). The item scores are added. Scores above 10 indicate a probable major depression. Scores above 18 indicate a definite major depression. Scores below 6 as a rule are associated with absence of significant depressive symptoms. INTERVIEW WITH THE INFORMANT Who qualifies as an Informant? Informants should know and have frequent contact with the patient. Reliable informants can include nursing staff for patients in the hospital and nursing homes or a family member for outpatients.

Effect of Bright Light Exposure on Depression and Agitation in Older Adults with Dementia

“…The CSDD has 19 items, each with three response options and has been shown to have an inter-rater reliability of kappa = -0.67 and internal consistency of Cronbach's α = 0.84 (Alexopoulos, Abrams, Young, & Shamoian, 1988). The validity of the CSDD was assessed by obtaining the correlation between CSDD scores and diagnoses given by psychiatrists using Research Diagnostic Criteria (r = 0.83).…”

Psychometric Properties of the Depressive Symptom Assessment for Older Adults in Individuals with Moderate or Severe Dementia

“…was administered to determine the older adult's degree of dementia (moderate or severe). The Depressive Symptom Assessment for Older Adults (DSA) (Onega, 2006(Onega, , 2008, the Dementia Mood Assessment Scale (DMAS) (Sunderland et al, 1988a(Sunderland et al, , 1988bSunderland & Minichiello, 1992), and the Cornell Scale for Depression in Dementia (CSDD) (Alexopoulos et al, 1988) were then administered. In addition to interviewing and observing the participant, the chart was reviewed.…”

“…Neither focuses on items such as lack of connection with others (loneliness) or lack of peace of mind. The intent of the DSA is to build on the existing work of the researchers who developed the Hamilton Rating Scale for Depression (Bagby, Ryder, Schuller, & Marshall, 2004;Hamilton, 1967;Williams, 2001), the DMAS (Sunderland, Alterman et al, 1988;, and the CSDD (Alexopoulos et al, 1988) to establish an instrument that assesses present and sequential depression in older adults, regardless of existing or future cognitive impairment, and incorporates important items that have not previously been measured (Onega, 2008).…”

“…Although previously tested for reliability in samples of older adults with dementia (Alexopoulos et al, 1988;Sunderland, Alterman et al, 1988), internal consistency was obtained on the DMAS and the CSDD, as these instruments were used to determine validity of the DSA.…”

“…The instrument is categorized by mood-related signs, behavioral disturbance, physical signs, cyclic functions, and ideational disturbance. Internal consistency, inter-rater reliability, sensitivity, and concurrent validity for the CSDD were established by Alexopoulos et al (1988).…”