A scoping review of the measurement of depression in older adults with cognitive impairment

Objectives: Depression and cognitive impairment are disabling conditions that commonly occur together in older adults. The interaction is challenging when choosing appropriate measurement scales. This review aimed to summarise the scales to measure depression symptoms in older people with cognitive impairment, investigating how cognitive impairment is related to the choice of measurement, and how the setting may affect the choice of measurement. Methods: A scoping review of literature published between 2015-2021. Results: After screening 1580 articles, 26 were included in the review with 11 different measures of depression symptoms identified. The measures mostly commonly used were the Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD) and the Neuropsychiatric Inventory (NPI-Q). Most studies did not report on the usability of depression scales used with people with cognitive impairment and only two scales (CSDD and NPI-Q, not GDS) have been validated for use with this population. Conclusions: Severe cognitive impairment was under-represented in the identified studies, and no association was detected between study setting, cognitive impairment and type of measure used. Clinical Implications: Clinicians and researchers should consider both the cognitive status of participants and the setting they live in when choosing a measure of depression symptoms.