The Adaptation and Validation of an Arabic Version of the Cornell Scale for Depression in Dementia (A-CSDD)

Abstract

Background: Depression is a major disorder that can be ttriggering, exacerbating, or co-occurring with dementia symptoms. Its assessment is paramount to achieve diagnostic, prognostic, and therapeutic decisions. The Cornell Scale for Depression in Dementia (CSDD) is purposely designed to address clinically this issue.

Objective: To examine the reliability and validity of an Arabic version of the CSDD (A-CSDD) in the Tunisian population.

Methods: Fifty-seven participants took part in this study: 20 as a control group (NC), 18 as dementia patients with depression (DD), and 19 as depressed patients without dementia (DND); all patients met the DSM IV criteria for depression and/or dementia. A translated, back-translated and adapted Arabic version of the CSDD was administered in parallel with the Geriatric Depression Scale (GDS), the non-cognitive part of the Alzheimer's disease Assessment Scale, and the Mini-Mental State Examination.

Results: The A-CSDD had good internal consistency (Cronbach's alpha = 0.85) and high test-retest reliability (Rho = 0.897, p < 0.001). The A-CSDD had excellent discriminatory power to diagnose depression in dementia patients (AUC = 0.90, p < 0.001) and good concurrent validity with the GDS (Rho = 0.70, p < 0.001). A principal component analysis with varimax rotation, performed on the DD group, led to a configuration of five factors explaining 75% of the variance.

Conclusions: The results showed that this Arabic-Tunisian version of the A-CSDD is reliable and valid for diagnosing depression in an elderly Tunisian population with dementia and can be used in clinical and research settings.

Keywords: Arabic version; Cornell Scale for Depression in Dementia; culture; dementia; depression; normative data; reliability; test adaptation; validity.