Validation and Reliability of the “SLU-AMSAD” Depression Scale in Individuals With Dementia

AI Summary

SLU-AMSAD is valid and practical for screening depression in older adults with dementia; recommend integration into clinical dementia assessment.
Caregiver-reported SLU-AMSAD showed strong correlation with CSDD (r=0.875) and excellent accuracy at cutoff ≥3: sensitivity 95.3%, specificity 93.6%, AUC 0.984.
Patient-reported SLU-AMSAD had moderate correlation and lower diagnostic performance: sensitivity 59.4%, specificity 83%, AUC 0.731.

AI Summary

While the Cornell Scale for Depression in Dementia (CSDD) is the gold standard for screening, the Saint Louis University-Appetite, Mood, Sleep, Activity, and Thoughts of Death (SLU-AMSAD), another brief screening tool designed to assess late-life depression, seems to be more practical than the CSDD, with a shorter test duration.

With an optimal cutoff of ≥3, diagnostic performance was substantially stronger for the caregiver-reported SLU-AMSAD-achieving 95.3% sensitivity and 93.6% specificity (AUC, 0.984; 95% CI, 0.965-1.000; P <.001)-whereas the patient-reported SLU-AMSAD yielded a sensitivity of 59.4% and a specificity of 83% (AUC, 0.731; 95% CI, 0.638-0.823; P <.001).

Basic summary

J Am Med Dir Assoc. 2026 Jul 7;27(9):106371. doi: 10.1016/j.jamda.2026.106371. Online ahead of print.

ABSTRACT

OBJECTIVES: The diagnosis of depression may be challenging in older adults with dementia because of atypical symptoms and overlap with other comorbidities. While the Cornell Scale for Depression in Dementia (CSDD) is the gold standard for screening, the Saint Louis University-Appetite, Mood, Sleep, Activity, and Thoughts of Death (SLU-AMSAD), another brief screening tool designed to assess late-life depression, seems to be more practical than the CSDD, with a shorter test duration.

DESIGN: Cross-sectional validation study.

SETTING AND PARTICIPANTS: In this study, conducted at a geriatric outpatient clinic, a total of 111 patients with dementia were enrolled, and both depression and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria.

METHODS: The SLU-AMSAD was administered to both patients and caregivers, along with the CSDD. Spearman’s rank correlation coefficient was used to assess the correlation between the SLU-AMSAD and CSDD. The diagnostic accuracy of the SLU-AMSAD was evaluated using receiver operating characteristic analysis, with the area under the curve (AUC).

RESULTS: Caregiver-reported SLU-AMSAD scores demonstrated a strong correlation with CSDD (r = 0.875; P < .001), whereas patient-reported SLU-AMSAD scores exhibited a moderate positive correlation (r = 0.384; P < .001). With an optimal cutoff of ≥3, diagnostic performance was substantially stronger for the caregiver-reported SLU-AMSAD-achieving 95.3% sensitivity and 93.6% specificity (AUC, 0.984; 95% CI, 0.965-1.000; P < .001)-whereas the patient-reported SLU-AMSAD yielded a sensitivity of 59.4% and a specificity of 83% (AUC, 0.731; 95% CI, 0.638-0.823; P < .001).

CONCLUSIONS AND IMPLICATIONS: The SLU-AMSAD is a valid and practical screening tool for depression in older adults with dementia. Given the shorter duration and strong caregiver-reported performance, it should be integrated into clinical dementia assessment, facilitating early detection and intervention for depression in such a vulnerable patient group.

PMID:42413154 | DOI:10.1016/j.jamda.2026.106371

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