Hostname: page-component-78c5997874-4rdpn Total loading time: 0 Render date: 2024-11-13T07:49:27.978Z Has data issue: false hasContentIssue false
  • English
  • Français

Validation of Montgomery-Åsberg Rating Scale and Cornell Scale for Depression in Dementia in Brazilian elderly patients

Published online by Cambridge University Press:  20 December 2011

Maria da Glória Portugal ,
Evandro Silva Freire Coutinho ,
Cloyra Almeida ,
Maria Lage Barca ,
Anne-Brita Knapskog ,
Knut Engedal  and
Jerson Laks
Maria da Glória Portugal*
Affiliation:
Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Evandro Silva Freire Coutinho
Affiliation:
National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
Cloyra Almeida
Affiliation:
Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
Maria Lage Barca
Affiliation:
Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Ullevaal University Hospital, Faculty of Medicine, University of Oslo, Norway
Anne-Brita Knapskog
Affiliation:
Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Ullevaal University Hospital, Faculty of Medicine, University of Oslo, Norway
Knut Engedal
Affiliation:
Norwegian Centre for Dementia Research, Centre for Ageing and Health, Department of Geriatric Medicine, Ullevaal University Hospital, Faculty of Medicine, University of Oslo, Norway
Jerson Laks
Affiliation:
Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
*
Correspondence should be addressed to: Maria da Glória Portugal, Center for Alzheimer's Disease, Institute of Psychiatry, Federal University of Rio de Janeiro, Av. Nossa Senhora de Copacabana, 680/314, Bairro Copacabana, 22050-001, Rio de Janeiro- RJ, Brazil. Phone: +55 21 2255 3454; Fax: +55 21 2235 6320. Email: gloria_portugal@yahoo.com.br.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: There are few studies on validation of depression scales in the elderly in Latin America. This study aimed to assess the validity of Montgomery-Åsberg. Depression Rating Scale (MADRS) and Cornell Scale for Depression in Dementia (CSDD) in Brazilian elderly outpatients.

Methods: A convenience sample of 95 outpatients was diagnosed for dementia and depression according to DSM-IV-TR, ICD-10, and PDC-dAD criteria. Receiver Operating Curves (ROC) were used to calculate the area under the curve (AUC) and to assess MADRS and CSDD cut-offs for each diagnostic criterion.

Results: Dementia was diagnosed in 71 of 95 patients. Depression was diagnosed in 35, 30, and 51 patients by ICD-10, DSM-IV, and PDC-dAD, respectively. MADRS cut-off score of 10 correctly diagnosed 67.4% and 66.3% patients as depressed according to DSM-IV and ICD-10. A cut-off of 9 correctly identified 74.7% by PDC-dAD criteria; a CSDD cut-off score of 13 best recognized depression according to DSM-IV and ICD-10. A score of 11 diagnosed depression according to PDC-dAD, while MADRS = 9 recognized depression in dementia. CSDD was more efficient in showing depression in mild than in moderate/severe dementia according to DSM-IV/ICD-10. PDC-dAD behaved nicely for any severity stage.

Conclusion: MADRS and CSDD cut-offs of 10 and 13 were the optimal ones to diagnose depression in elderly, respectively. CSDD cut-offs are higher than those found in other countries. Other Latin American studies are needed to compare results with our study.

Keywords

MADRSCSDDdepressiondementiadiagnostic criteria
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1291 - 1298
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alexopoulos, G. S., Abrams, R. C., Young, R. C. and Shamoian, C. A. (1988). Cornell Scale for Depression in Dementia. Biological Psychiatry, 23, 271–284.CrossRefGoogle ScholarPubMed
APA (American Psychiatric Association) (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association.Google Scholar
Barca, M. L., Engedal, K. and Selbaek, G. (2010). A reliability and validity study of the Cornell scale among elderly inpatients, using various clinical criteria. Dementia and Geriatric Cognitive Disorders, 29, 438–447. doi: 10.1159/000313533.CrossRefGoogle ScholarPubMed
Barca, M. L., Selbaek, G., Laks, J. and Engedal, K. (2008). The pattern of depressive symptoms and factor analysis of the Cornell scale among patients in Norwegian nursing homes. International Journal of Geriatric Psychiatry, 23, 1058–1065. doi: 10.1002/gps.2033.CrossRefGoogle ScholarPubMed
Bertolucci, P. H., Brucki, S. M., Campacci, S. R. and Juliano, Y. (1994). O mini-exame do estado mental em uma população geral: impacto da escolaridade. Arquivos de Neuro-psiquiatria, 52, 1–7.CrossRefGoogle Scholar
Camozzato, A. L. et al. (2008). Reliability of the Brazilian Portuguese version of the Neuropsychiatric Inventory (NPI) for patients with Alzheimer's disease and their caregivers. International Psychogeriatrics, 20, 383–393. doi:10.1017/S1041610207006254.CrossRefGoogle ScholarPubMed
Carthery-Goulart, M. T. et al. (2007). Brazilian version of the Cornell Depression Scale in Dementia. Arquivos de Neuro-psiquiatria, 65, 912–915. doi: 10.1590/S0004-282X2007000500037.CrossRefGoogle ScholarPubMed
Chaves, M. L. et al. (2007). Validity of the Clinical Dementia Rating scale for the detection and staging of dementia in Brazilian patients. Alzheimer Disease and Associated Disorders, 21, 210–217.CrossRefGoogle ScholarPubMed
Cummings, J. L., Mega, M., Gray, K., Rosenberg-Thompson, S., Carusi, D. A. and Gornbein, J. (1994). The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.CrossRefGoogle ScholarPubMed
Debruyne, H. et al. (2009). Is the Geriatric Depression Scale a reliable screening tool for depressive symptoms in elderly patients with cognitive impairment? International Journal of Geriatric Psychiatry, 24, 556–562. doi: 10.1002/gps.2154.CrossRefGoogle Scholar
Dratcu, L., da Costa Ribeiro, L. and Calil, H. M. (1987). Depression assessment in Brazil: the first application of the Montgomery-Åsberg depression rating scale. British Journal of Psychiatry, 150, 797–800.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Hughes, C. P., Berg, L., Danziger, W. L., Coben, L. A. and Martin, R. L. (1982). A new clinical scale for the staging of dementia. British Journal of Psychiatry, 140, 566–572.CrossRefGoogle ScholarPubMed
Inouye, K., Pedrazzani, E. S., Pavarini, S. C. I. and Toyoda, C. Y. (2010). Quality of life of elderly with Alzheimer's disease: a comparative study between the patient's and the caregiver's report. Revista Latino-Americana de Enfermagem, 18, 26–32. doi: 10.1590/S0104-11692010000100005.CrossRefGoogle Scholar
Judd, L. L. and Akiskal, H. (2002). The clinical and public health relevance of current research on subthreshold depressive symptoms to elderly patients. American Journal of Geriatric Psychiatry, 10, 233–238.CrossRefGoogle Scholar
Krause, N. and Goldenhar, L. M. (1992). Acculturation and psychological distress in three groups of elderly Hispanics. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 47, S279–S288.Google ScholarPubMed
Laks, J. and Engelhardt, E. (2010). Peculiarities of geriatric psychiatry: a focus on aging and depression. CNS Neuroscience & Therapeutics, 16, 374–379.CrossRefGoogle ScholarPubMed
Lam, C. K., Lim, P. P. J., Low, B. L., Ng, L. L., Chiam, P. C. and Sahadevan, S. (2004). Depression in dementia: a comparative and validation study of four brief scales in the elderly Chinese. International Journal of Geriatric Psychiatry, 19, 422–428. doi: 10.1002/gps.1098.CrossRefGoogle ScholarPubMed
Leentjens, A. F. G., Verhey, F. R. J., Lousberg, R., Spitsbergen, H. and Wilmink, F. W. (2000). The validity of the Hamilton and Montgomery-Åsberg depression rating scales as screening and diagnostic tools for depression in Parkinson's disease. International Journal of Geriatric Psychiatry, 15, 644–649.3.0.CO;2-L>CrossRefGoogle ScholarPubMed
Leontjevas, R., van Hooren, S. and Mulders, A. (2009). The Montgomery-Åsberg depression rating scale and the Cornell scale for depression in dementia: a validation study with patients exhibiting early-onset dementia. American Journal of Geriatric Psychiatry, 17, 56–64. doi: 10.1097/JGP.0b013e31818b4111.CrossRefGoogle ScholarPubMed
Logsdon, R. G., Gibbons, L. E., McCurry, S. M. and Teri, L. (2002). Assessing quality of life in older adults with cognitive impairment. Psychosomatic Medicine, 64, 510–519.CrossRefGoogle ScholarPubMed
Montgomery, A. S. and Åsberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389.CrossRefGoogle ScholarPubMed
Müller-Thomsen, T., Arlt, S., Mann, U., Mass, R. and Ganzer, S. (2005). Detecting depression in Alzheimer's disease: evaluation of four different scales. Archives of Clinical Neuropsychology, 20, 271–276.CrossRefGoogle ScholarPubMed
Olin, J. T., Katz, I. R., Meyers, B. S., Schneider, L. S. and Lebowitz, B. D. (2002). Provisional diagnostic criteria for depression of Alzheimer disease: rationale and background. American Journal of Geriatric Psychiatry, 10, 129–141.CrossRefGoogle ScholarPubMed
Porta-Etessam, J., Tobaruela-González, J. L. and Rabes-Berendes, C. (in press). Depression in patients with moderate Alzheimer disease: a prospective observational cohort study. Alzheimer Disease and Associated Disorders.Google Scholar
Pujol, J., De Azpiazu, P., Salamero, M. and Cuevas, R. (2001). Depressive symptoms in dementia – the Cornell scale: validation of the Spanish version. Revista de Neurologia, 33, 397–398.Google ScholarPubMed
Relkin, N. (2000). Screening and early diagnosis of dementia. American Journal of Managed Care, 6 (Suppl. 22), S1111–S1118; discussion S1119–S1124.Google ScholarPubMed
Schreiner, A. S., Hayakawa, H., Morimoto, T. and Kakuma, T. (2003). Screening for late life depression: cut-off scores for the Geriatric Depression Scale and the Cornell Scale for Depression in Dementia among Japanese subjects. International Journal of Geriatric Psychiatry, 18, 498–505.CrossRefGoogle ScholarPubMed
Silberman, C. D., Laks, J., Capitão, C. F., Rodrigues, C. S., Moreira, I. and Engelhardt, E. (2006). Recognizing depression in patients with Parkinson's disease: accuracy and specificity of two depression rating scales. Arquivos de Neuro-psiquiatria, 64, 407–411. doi: 10.1590/S0004-282X2006000300011.CrossRefGoogle Scholar
Silveira, M. J., Given, C. W., Given, B., Rosland, A. M. and Piette, J. D. (2010). Patient–caregiver concordance in symptom assessment and improvement in outcomes for patients undergoing cancer chemotherapy. Chronic Illness, 6, 46–56. doi:10.1177/1742395309359208.CrossRefGoogle ScholarPubMed
Slawek, J., Derejko, M. and Lass, P. (2003). Depression in patients with Parkinson's disease. Neurologia i Neurochirurgia Polska, 37, 351–364.Google ScholarPubMed
Spiegel, R. et al. (1991). A new behavioral assessment scale for geriatric out- and in-patients: The NOSGER (Nurses’ Observation Scale for Geriatric Patients). Journal of the American Geriatrics Society, 39, 339–347.CrossRefGoogle ScholarPubMed
Stata Corp (2007). Stata Statistical Software: Release 10. College Station, TX: Stata Corp LP.Google Scholar
Tran, T. V. and Dhooper, S. S. (1997). Poverty, chronic stress, ethnicity and psychological distress among elderly Hispanics. Journal of Gerontological Social Work, 27, 3–19.CrossRefGoogle Scholar
Vida, S., Des Rosiers, R., Carrier, L. and Gauthier, S. (1994). Depression in Alzheimer's disease: receiver operating characteristic analysis of the Cornell Scale for Depression in Dementia and the Hamilton Depression Scale. Journal of Geriatric Psychiatry and Neurology, 7, 159–162.CrossRefGoogle ScholarPubMed
Wagenaar, D. B., Mickus, M. A., Gaumer, K. A. and Colenda, C. C. (2002). Late-life depression and mental health services in primary care. Journal of Geriatric Psychiatry and Neurology, 15, 134–140.CrossRefGoogle ScholarPubMed
Watson, L. C., Lewis, C. L., Moore, C. G. and Jeste, D. V. (2011). Perceptions of depression among dementia caregivers: findings from the CATIE-AD trial. International Journal of Geriatric Psychiatry, 26, 397–402. doi: 10.1002/gps.2539.CrossRefGoogle ScholarPubMed
WHO (World Health Organization) (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: WHO.Google Scholar