Geriatric Depression Scale (GDS)

The Geriatric Depression Scale was developed by Yesavage, Brink, Rose, Lum, Huang, Adey, and Leirer (1982). It was designed specifically for the aged, as a screening instrument for depression. The scale

  • Originally contained 100 items, but was condensed to 30 Is a self-administered test, but can be used in observer-administered formats also
  • The 30 items are yes/no questions.

Later, Sheik & Yesavage (1986) created a short form of the GDS (GDS-SF), which contained 15 items. The original can be referred to as the GDS- Long Form (GDS-LF). Literature is divided in terms of the short form being a suitable substitute (Aikman& Oehlert, 2001; Holroyd & Clayton, 2000).

Cut-off scores for different severities of depression are as follows:

For the long form: Normal 0 – 10, Mild 11 – 20, Moderate to Severe 21 – 30.

For the short form: Normal 0 – 4, Mild 5 – 9, Moderate to Severe 10 – 15.

Validation and Psychometric properties

The scale has a high degree of internal consistency, with a Chronbach’s alpha coefficient of .94, and split-half reliability score of .94. Test retest reliabilities of .85 (p < .001) for one week apart (Yesavage et. al., 1982) and .85 (p < .001) for one month apart (Parmelee, Lawton & Katz, 1989) show that within the time limits, scores reflect stable individual differences.

The GDS is a valid tool for discriminating symptom severity, and presence vs absence based on DSM-IV criteria, but not among different diagnostic groups. It should not be used as a single diagnostic measure (Watson, Zimmerman, Cohen, & Dominik, 2009).

The GDS has high correlations with the Zung Self-Rating Depression Scale (SDS) and the Hamilton Rating Scale for Depression (HRS-D) (.84 and .83 respectively); further evidence of validity.

Sensitivity (true positives) and specificity (true negatives) with a cutoff of 11 were 84% and 95% respectively, and they were 80% and 100% respectively at a cutoff of 14; providing evidence for scores of 11+ to be considered a possible indicator of depression.

Validity and reliability are unaffected by pertinent individual difference factors such as age, education, gender, race, and culture (Marc, Raue & Bruce, 2008; Rait et. al., 1999; Harralson et. al., 2002).

Critical Analysis

Overall, the GDS-LF is a reliable and valid measure of depression in aged individuals. It is…

  • Easy to administer (self-administered or observer)
  • A simple scale to complete (yes/no responses), especially for older adults
  • Useful in a variety of settings; nursing homes and the community, with medical inpatients, medical outpatients, and day-treatment clients
  • Shown to maintain it’s reliability and validity when administered by phone (Burke, Roccaforte, Wengel, Conley & Potter (1995)
  • Adequate in screening mildly demented subjects (McGivney, Mulvihill & Taylor, 1994)

Its few weaknesses include the possibility of over-diagnosing depression (Lesher & Berryhill, 1994), the inclusion of items/terms that could be seen as western value judgments (Sansoni et. al., 2007) and that it is not a useful or valid tool for screening cognitively impaired patients (Holroyd & Clayton, 2000).

It is a useful screening tool for depression in older adults.

Links

Original Source, and Various Translations:

Online Version:

References

Aikman, G. G., & Oehlert, M. E. (2001). Geriatric Depression Scale: long form versus short form. Clinical Gerontologist, 22(3-4), 63-70.

Burke, W. J., Roccaforte, W. H., Wengel, S. P., Conley, D. M., & Potter, J. F. (1995). The reliability and validity of the Geriatric Depression Rating Scale administered by telephone. Journal of the American Geriatrics Society43(6), 674-679.

Harralson, T. L., White, T. M., Regenberg, A. C., Kallan, M. J., Ten Have, T., Parmelee, P. A., & Johnsons, J. C. (2002). Similarities and differences in depression among black and white nursing home residents. The American journal of geriatric psychiatry, 10(2), 175-184

Holroyd & Clayton (2000). Measuring Depression in the Elderly: Which Scale is Best? Medscape. Retrieved 20/08/2017 from http://www.medscape.com/viewarticle/430554_3

Lesher, E. L., & Berryhill, J. S. (1994). Validation of the geriatric depression scale‐short form among inpatients. Journal of clinical psychology, 50(2), 256-260.

Marc, L. G., Raue, P. J., & Bruce, M. L. (2008). Screening performance of the 15-item geriatric depression scale in a diverse elderly home care population. The American Journal of Geriatric Psychiatry, 16(11), 914-921.

McGivney, S. A., Mulvihill, M., & Taylor, B. (1994). Validating the GDS depression screen in the nursing home. Journal of the American Geriatrics Society, 42(5), 490-492

Parmelee, P. A., Lawton, M. P., & Katz, I. R. (1989). Psychometric properties of the Geriatric Depression Scale among the institutionalized aged. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 1(4), 331.

Rait, G., Burns, A., Baldwim, R. Morley, M., Chew-Graham, C., St Leger, A. S., & Abas, M. (1999). Screening for depression in African-Caribbean elders. Family practice, 16(6), 591-595

Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version. Clinical Gerontologist, 5, 165-173.

Watson, L. C., Zimmerman, S., Cohen, L. W., & Dominik, R. (2009). Practical depression screening in residential care/assisted living: five methods compared with gold standard diagnoses. The American Journal of Geriatric Psychiatry, 17(7), 556-564.

Yesavage, J. A., Brink, T. L., Rose, T. L., Lum, O., Huang, V., Adey, M., & Leirer, V. O. (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of psychiatric research, 17(1), 37-49.