Nijmegen Observer-Rated Depression scale for detection of depression in nursing home residents

Authors

  • Ruslan Leontjevas,

    Corresponding author
    1. School of Psychology, Open University of the Netherlands
    • Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands
    Search for more papers by this author
  • Debby L. Gerritsen,

    1. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands
    Search for more papers by this author
  • Myrra J. F. J. Vernooij-Dassen,

    1. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands
    2. Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, The Netherlands
    3. Kalorama Foundation, Beek-Ubbergen, The Netherlands
    Search for more papers by this author
  • Steven Teerenstra,

    1. Department of Epidemiology, Biostatistics, and HTA, Radboud University Nijmegen Medical Centre, The Netherlands
    Search for more papers by this author
  • Martin Smalbrugge,

    1. Department of Nursing Home Medicine, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
    Search for more papers by this author
  • Raymond T. C. M. Koopmans

    1. Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands
    Search for more papers by this author

R. Leontjevas, MSc, Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, The Netherlands. E-mail: R.Leontjevas@elg.umcn.nl

Abstract

Objective

This study aims to test the accuracy of the Nijmegen Observer-Rated Depression (NORD) scale, a new short scale for screening of depression in nursing home (NH) residents with and without dementia.

Methods

This cross-sectional study with 103 residents with dementia (N = 19 depressed) and 72 residents without dementia (N = 10 depressed) was undertaken in 13 Dutch NH units. An elderly care physician and a psychologist of each unit assessed residents for the presence of clinical depression. Primary professional caregivers administered the NORD scale.

Results

Five of the six proposed items showed acceptable performance in screening for depression. Receiver operating characteristic analyses revealed significant areas under the empirical curve (AUC) for the 5-item NORD scale in the total sample (AUC = 0.83, p < 0.001), as well as in residents with dementia (AUC = 0.84, p < 0.001) and without dementia (AUC = 0.84, p < 0.001). The cutoff score of >1 showed the highest sum of sensitivity (100) and specificity (69) in non-dementia and >2 the highest sum of sensitivity (79) and specificity (77) in dementia. The cutoff score of >1 showed the lowest negative likelihood ratio of 0.0 in non-dementia and of 0.2 in dementia. The highest positive likelihood ratios were found for the cutoff of >2 in non-dementia (3.4) and for >4 in dementia (26.5).

Conclusion

The 5-item NORD scale showed acceptable accuracy comparable with those of more extensive scales in other studies. It is easy and quick to administer and can be used for screening of depression in NH residents with or without dementia. Copyright © 2011 John Wiley & Sons, Ltd.

Ancillary