Reliability and Validity of the Cornell Scale for Depression in Dementia and Invariance Between Black Versus White Residents in Nursing Homes.
Barbara Resnick, Kimberly Van Haitsma, Ann Kolanowski and 5 others
PMID 34896057WHAT IT FOUND
Nursing home residents' Cornell depression ratings were consistent overall, but the scale may fit White residents better than Black residents.
In severe dementia, look for observable signs such as irritability rather than relying only on total scores.
Key findings
01The scale had very high internal consistency (alpha .98), and the suicide item showed a non-significant racial difference (p=.29).
02The scale appeared to measure one main depression concept and item fit was acceptable, but item mapping showed poor match between residents' symptoms and the items, with many residents too low in symptoms to be differentiated.
03Confirmatory models fit only fairly and were somewhat better for White residents, and the suicide item did not significantly load for Black residents.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The analysis used baseline data from two studies and only included residents with moderate to severe dementia. Most residents had very few depressive symptoms, so the scale may not perform the same in more depressed residents. The study was completed in only two states. Residents had to consent or assent, so those with significant depression may have been less likely to take part. Treatment for depression and antidepressant use were not considered. Model fit was only fair and item mapping showed poor match between symptoms and items.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude the CSDD is equally valid for Black and White residents just because no significant item bias was found. Model fit was only fair and somewhat better for White residents, and the suicide item did not significantly load for Black residents.