Age and Ageing, Vol 29, 165-172, Copyright © 2000 by British Geriatrics Society
A Burrows, J Morris, S Simon, J Hirdes and C Phillips
Background. Depression is common but under-diagnosed
in nursing-home residents. There is a need for a standardized screening
instrument which incorporates daily observations of nursing-home
staff.Aim. To develop and validate a screening
instrument for depression using items from the Minimum Data Set of the
Resident Assessment Instrument.Method. We conducted
semi-structured interviews with 108 residents from two nursing homes to
obtain depression ratings using the 17-item Hamilton Depression Rating
Scale and the Cornell Scale for Depression in Dementia. Nursing staff
completed Minimum Data Set assessments. In a randomly assigned derivation
sample (n
ARTICLES
Development of a minimum data set-based depression rating scale for use in nursing homes
Research and Training Institute, Hebrew Rehabilitation Center for Aged, 1200 Center Street, Boston, MA 02131, USA; Boston University Geriatric Services, Boston University School of Medicine, 88 East Newton Street, Boston, MA 02118, USA; Department of Health Studies and Gerontology, University of Waterloo and Research Department, Providence Center, Scarborough, Ontario, Canada; Myers Research Institute, Menorah Park Center for the Aging, Beachwood, OH, USA; Corresponding author; Fax: (+1) 617 474 0757; E-mail: adam.burrows@bmc.org
81) we identified Minimum Data Set mood
items that were correlated (P<0.05) with
Hamilton and Cornell ratings. These items were factored using an oblique
rotation to yield five conceptually distinct factors. Using linear
regression, each set of factored items was regressed against Hamilton and
Cornell ratings to identify a core set of seven Minimum Data Set mood items
which comprise the Minimum Data Set Depression Rating Scale. We then tested
the performance of the Minimum Data Set Depression Rating Scale against
accepted cut-offs and psychiatric diagnoses.Results. A
cutpoint score of 3 on the Minimum Data Set Depression Rating Scale
maximized sensitivity (94% for Hamilton, 78% for Cornell) with minimal loss
of specificity (72% for Hamilton, 77% for Cornell) when tested against
cut-offs for mild to moderate depression in the derivation sample. Results
were similar in the validation sample. When tested against diagnoses of
major or non-major depression in a subset of 82 subjects, sensitivity was
91% and specificity was 69%. Performance compared favourably with the
15-item Geriatric Depression Scale.Conclusion. Items
from the minimum Data Set can be organized to screen for depression in
nursing-home residents. Further testing of the instrument is now
needed.Keywords: depression rating scale, Minimum Data
Set, nursing homes
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