geriatrics psychiatry

Cornell Scale for Depression in Dementia (CSDD)

19-item observer-rated scale of depressive symptoms in dementia, drawing on informant and patient interviews (Alexopoulos 1988). Each item 0 (absent), 1 (mild or intermittent), 2 (severe); total 0–38. Scores above 10 indicate probable and above 18 definite major depression; below 6 usually no significant depressive symptoms.

Used in: Depression & Anxiety

Q1. Anxiety*

Q2. Sadness*

Q3. Lack of reactivity to pleasant events*

Q4. Irritability*

Q5. Agitation (restlessness, hand-wringing)*

Q6. Retardation (slow movement, slow speech, slow reactions)*

Q7. Multiple physical complaints*

Q8. Loss of interest*

Q9. Appetite loss*

Q10. Weight loss*

Q11. Lack of energy*

Q12. Diurnal variation of mood*

Q13. Difficulty falling asleep*

Q14. Multiple awakenings during sleep*

Q15. Early morning waking*

Q16. Suicide ideation*

Q17. Poor self-esteem*

Q18. Pessimism*

Q19. Mood-congruent delusions*

Score interpretation

No Significant Depressive Symptoms 0–5

CSDD < 6: as a rule, no significant depressive symptoms.

→ Reassess if behaviour or function declines. Optimise environment, social activity, sleep hygiene.

Some Depressive Symptoms — Below the Major-Depression Threshold 6–10

CSDD 6–10: above the 'no significant symptoms' range but not above 10.

→ Treat reversible contributors (pain, constipation, sleep, sensory loss, infection); non-pharmacological measures; re-rate after a few weeks.

Probable Major Depression 11–18

CSDD > 10: probable major depression.

→ Treat reversible contributors (pain, constipation, sleep, sensory loss, infection). Non-pharmacological first-line: structured activity, music therapy, light exposure. Trial SSRI (sertraline / citalopram); avoid TCAs.

Definite Major Depression 19–38

CSDD > 18: definite major depression.

→ Old-age psychiatry referral. Combine SSRI + non-pharmacological measures. Active suicide-risk assessment. Consider mirtazapine for poor appetite/sleep. ECT for severe / psychotic / treatment-resistant depression.

Interpretation bands for the Cornell-Depression. Apply clinical judgement and local guidance.

References

Curated clinical cross-links plus same-class fallbacks.

Calculators

Calgary Depression Scale for Schizophrenia (CDSS) · Mood

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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