Geriatric Depression Scale (GDS)

BioPsychoSocial Assessment Tools for the Elderly - Assessment Summary Sheet

Test: Geriatric Depression Scale (GDS)

Year: 1982

Domain: Psychological

Assessment Tool Category: Mental Health

Variations/Translations: There are 46 versions of the Geriatric Depression Scale, translated into 27 languages.

Setting: In-home or clinical setting

Method of Delivery: Self-administered or interview

Description: The GDS was designed as a screening tool for depression in elderly populations. It is a 30-item questionnaire that measures depressive symptoms and has been used extensively in the healthy older adult population with special emphasis on target populations such as the medically ill and mild to moderately cognitively impaired older adults. It has also been used in community, acute and long-term care settings. The time frame of the scale covers the past week.

Scoring/Interpretation: The original 30-item assessment test consists of closed-ended YES/NO questions. Depressive answers (bolded) are each given 1 point, and points are summed to obtain a total score. Scores ranging from 0-9 indicate “Normal,” 10-19 indicate “Mild Depressive,” and 20-30 indicate “Severe Depressive.” The shortened 15-item assessment test follows the same scoring procedure as above, with score ranges from 0-15. In the shortened version, scores of 0-4 are considered normal, 5-9 indicate mild depression, and 10-15 indicate moderate to severe depression (McDowell & Newell, 1996). The suggested method of adjusting scores if a patient misses/omits a question is as follows: “If say 3 of 15 items missed, total score is score on 12 completed PLUS 3/15ths of total score to make-up for omitted items, e.g. if they got a 4 on the 12 they completed or 1/3 positive, add 1/3 of the 3 missing or 1 point for a total of 5” (Yesavage & Brink, http://www.stanford.edu/~yesavage/GDS.html).

Time to Administer: 10-20 minutes

Availability: Both the original version and shortened version are available online (see below)

Software: N/A

Website: http://www.stanford.edu/~yesavage/GDS.html

Quantitative/Qualitative: Quantitative

Validity (Quantitative): Studies comparing the GDS to the Hamilton Rating Scale for Depression (HRSD) have shown high correlation between the two tools (correlation coefficients ranging from 0.58 to 0.82 have been reported). Studies have reported a high correlation between the GDS and the Montgomery-Asberg Depression Rating Scale (0.82) as well as between the GDS and the Beck Depression Inventory (0.85). Tests also reported that the GDS was able to discriminate between patients with different levels of depression, as scores were found to increase significantly with level of depression (r = 0.82). Sensitivity and specificity were found to be high, at 84% and 95% respectively when compared to the Self-rating Depression Scale (SDS) and HRSD. Ability to discriminate between depressed and non-depressed cognitively-impaired patients using the GDS has been tested extensively, with mixed results. While one study showed good ability to discriminate, several others showed poor to no discrimination between groups. A recent study demonstrated that at MMSE (Mini-Mental State Exam) scores below 14/15, the GDS performs poorly, whereas for scores of 15 or over for the MMSE the sensitivity was 84% and the specificity was 91% (McDowell, 2006).

Reliability (Quantitative): Numerous studies have shown that the GDS has high internal consistency (alpha coefficient > 0.80). Test-retest reliability of the GDS has also been shown to be high (0.85 at one week, 0.86 at one hour, and 0.98 at ten to twelve days) (McDowell & Newell, 1996).

References:

Brink, T. L., Yesavage, J. A., Lum, O., Heersema, P., Adey, M. B., & Rose, T. L. (1982). Screening tests for geriatric depression. Clinical Gerontologist, 1, 37-44.

McDowell, I., & Newell, C. (1996). Measuring Health: A Guide to Rating Scales and Questionnaires (2nd ed). New York: Oxford University Press.

Sheikh, J. I., & Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontology: A Guide to Assessment and Intervention. New York: The Haworth Press.

Sheikh, J. I., Yesavage, J. A., Brooks, J. O., III, Friedman, L. F., Gratzinger, P., Hill, R. et al. (1991). Proposed factor structure of the Geriatric Depression Scale. International Psychogeriatrics, 3, 23-28.

Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M. B., & Leirer, V. O. (1983). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.

Comments: N/A