A Comparison of the Cornell Scale for Depression in Dementia and the Montgomery-Aasberg Depression Rating Scale in a Memory Clinic Population

Abstract

Background: The aim of this study was to explore the correlation between the Cornell Scale for Depression in Dementia (CSDD) and the Montgomery-Aasberg Depression Rating Scale (MADRS) among memory clinic patients. Methods: The CSDD (based on an interview with the caregiver) and the MADRS (based on the patient's opinion) were filled in independently of each other among 520 patients. Principal component and correlation analyses were performed. Results: The mean score of the CSDD was 7.6 (SD: 6.0), and the mean MADRS score was 9.7 (SD: 6.7). The correlation between the two scales was 0.36 for the whole group, 0.22 in the group with dementia and 0.48 for those without dementia, respectively. Principal component analyses revealed four factors for the CSDD and two factors for the MADRS. Conclusions: Using two different sources of information, we found a poor correlation between the two scales. We suggest that evaluation of depression among memory clinic patients should be done by interviewing both the patient and the caregiver.

Trajectories of Depression in Late Life: A 1-Year Follow-Up Study

“…Symptoms of depression and dementia may overlap and often should be considered together [6,[16][17][18][19][20][21] . Hence, observational longitudinal studies on the outcome of DLL in different clinical settings are still warranted [4,10,22] .…”

Medial Temporal Lobe Atrophy and Depressive Symptoms in Elderly Patients With and Without Alzheimer Disease

“…In the original publication a total score above 7/8 has been suggested as cut-off, but no sensitivity, specificity, positive and negative likelihood ratios and accuracy values were calculated for that cut-off point or other cut-off points 216 . Cut-off points with the best sensitivity, specificity and accuracy vary among patient populations, cultural differences and study designs 220 . For example in a nursing home Norwegian population a cut-off 8/9 has the best accuracy for diagnosing ICD-10 major depression, a cut-off 10/11 has the best accuracy for DSM-IV-TR major depression while a cut-off 6/7 has the best accuracy for diagnosing depression in AD using the Provisional Criteria for Depression in Alzheimer…”

“…Moreover, the Swedish version of the scale used for this study is not validated in a Swedish population, most of the validation studies were in culturally similar populations from Norway 220 and Denmark 218 . However, the CSDD is the recommended tool for assessing depressive symptoms in people with cognitive impairment 238 , and has been shown good psychometric properties 220 . Throughout the thesis we used several cut-off points on CSDD to define depressive symptoms.…”

“…Throughout the thesis we used several cut-off points on CSDD to define depressive symptoms. We used 2 cut-off points, which are validated in a Danish (6/7) 218 , and a Norwegian (7/8) cohort of out patients 220 . In study II we defined depressive symptoms as a CSDD score more and equal 8 or use of antidepressant treatment 140 , as it have been suggested that information on use of antidepressant treatment can improve the classification accuracy 140 .…”

“…It takes around 20-30 minutes to administer.Like MADRS, it is less useful in assessing depression in dementia.This scale is designed to assess the presence of neuropsychological symptoms in AD. As NPI it takes around 10 minutes to administer to a caregiver or an informant and a question about presence of depressive symptoms is included.Scales assessing more affective symptoms as MADRS, HAM-D and GDS-15, GDS-10, GDS-4 are better correlated among themselves225 231 , while a relatively poor correlation had been recently reported between CSDD and MADRS220 . Moreover, use of MADRS had a better accuracy in predicting major depression assessed by ICD-10 in a memory clinic population222 .In AD, the scoring of scales based on self-reported depressive symptoms such as MADRS, GDS and HAM-D can be influenced by the patient's communication skills, insight, and ability to abstract thinking.…”