Considerations for Use of the Cornell Scale for Depression in Dementia Among Assisted Living Residents: Factor Analysis Results

The Cornell Scale for Depression in Dementia (CSDD) is widely used to assess depressive symptoms, but its factor structure has not been well explored in assisted living (AL) residents. An appropriate measure of depressive symptoms for this population is crucial to ensure accurate detection of depression. This study tested the CSDD's factor structure in 511 AL residents from 85 facilities using baseline data from a randomized trial. Confirmatory factor analyses and chi-square difference tests were conducted. Three items were removed due to low factor loadings. The five-factor model fit significantly better (χ² = 796.08, ∆χ² = 22.86, ∆<i>df</i> = 4, <i>p</i> < .001) than the four-factor model, although both showed poor fit. These results offer partial support for the modified five-factor CSDD in assessing depression among AL residents. Future research should explore more appropriate depression measures for this population, potentially incorporating items that more accurately capture depressive symptoms in AL residents.Parent study trial registry nameDissemination and Implementation of Function Focused Care for Assisted Living (NCT03459118).