The course of depressive symptoms as measured by the Cornell scale for depression in dementia over 74 months in 1158 nursing home residents

Background: Depressive symptoms and depression are common in nursing home residents. However, longitudinal studies of depression in nursing home residents are scarce and the sample sizes are small. This study aimed to investigate the course of depressive symptoms as measured by the Cornell Scale for Depression in Dementia (CSDD) and associated explanatory demographic and clinical variables. Methods: A longitudinal study over 74 months of 1158 nursing home residents aged 50 years and older from twenty six nursing homes in Norway where data was collected at five time points. Results: irritability was the most prevalent, incident and persistent CSDD symptom. Compared with the baseline assessment, the likelihood of the mood symptoms suicidal ideation, pessimism and delusions being present was lower at all subsequent assessments. This persisted after adjusting for the severity of dementia. The severity of depression as measured by CSDD decreased over 74 months when adjusting for relevant resident variables. Poorer physical health, higher number of medications, more severe dementia and use of antidepressants were associated with higher depression score. Limitations: Depression and dementia were not diagnosed according to standardized diagnostic criteria. The use of CSDD did not include a clinician's interview with the patient. This could have implications for the generalization of the results. Conclusion: This study adds important knowledge about the long-term course of depressive symptoms and depression for residents in nursing homes, and underlines the importance to pay close attention to the overlap between depression and dementia symptoms when evaluating depression in this setting. (C) 2014 Elsevier B.V. All rights reserved.