Geriatric Depression Scale Content and Scoring

Overview

The Geriatric Depression Scale (GDS) is a widely used instrument for screening depressive symptoms in older adults. Developed in 1982 by J.A. Yesavage and colleagues, the GDS has become an essential tool in various healthcare settings, including primary care, psychiatry, and geriatrics.

Utility and Significance

• High Prevalence: Depression among elderly individuals is prevalent, affecting up to 15% of community-dwelling seniors.
• Reliable Screening: The GDS is a reliable and effective tool in detecting depressive symptoms among older adults.
• Diverse Applicability: It is suitable for use in both healthy and medically ill elderly populations, including those with cognitive impairments.
• Clinical Utility: The GDS helps clinicians identify individuals who may require further evaluation and treatment for depression.

Unique Features

The GDS distinguishes itself from depression screening tools designed for younger adults by focusing on psychiatric symptoms rather than somatic symptoms.

• Symptom Focus: Conditions like weight loss, pessimism, and sleep disturbances, often associated with aging itself, may not necessarily indicate depression in older adults.
• Psychiatric Emphasis: The GDS emphasizes psychiatric symptoms, such as anhedonia, hopelessness, and feelings of worthlessness, which are more representative of depression in this population.

GDS Versions

The GDS exists in multiple forms, catering to different settings and needs:

1. GDS-30: The original long-form GDS, consisting of 30 questions.

2. GDS-15: A shortened version with 15 questions, providing greater efficiency while maintaining accuracy.

3. 4- and 5-Item Versions: Even briefer versions with four or five questions, though their accuracy is subject to debate.

GDS Questionnaires

The GDS-15 consists of 15 questions that explore an individual's feelings and experiences during the past week. Participants select the answer that best reflects their current state.

1. Are you basically satisfied with your life? (YES/NO) 2. Have you dropped many of your activities and interests? (YES/NO) 3. Do you feel that your life is empty? (YES/NO) 4. Do you often get bored? (YES/NO) 5. Are you in good spirits most of the time? (YES/NO) 6. Are you afraid that something bad is going to happen to you? (YES/NO) 7. Do you feel happy most of the time? (YES/NO) 8. Do you often feel helpless? (YES/NO) 9. Do you prefer to stay at home, rather than going out and doing new things? (YES/NO) 10. Do you feel you have more problems with memory than most? (YES/NO) 11. Do you think it is wonderful to be alive now? (YES/NO) 12. Do you feel pretty worthless the way you are now? (YES/NO) 13. Do you feel full of energy? (YES/NO) 14. Do you feel that your situation is hopeless? (YES/NO) 15. Do you think that most people are better off than you are? (YES/NO)

Scoring Procedure

Scoring the GDS-15 follows a simple method:

• Each answer suggestive of depression is assigned one point.
• Higher scores indicate more severe depressive symptoms.

0-4 Points: Depression is unlikely. 5-9 Points: Suggests the possibility of depression and warrants further assessment. 10-15 Points: Indicates a high likelihood of depression and requires immediate attention.

Interpretation

• Scores above 5 necessitate a comprehensive evaluation for depression.
• Scores at or above 10 strongly indicate depression and demand prompt intervention.

Benefits of the GDS

The GDS offers several advantages in practice:

• Cost-Effective: The GDS is free to use, making it accessible to a wide range of healthcare providers.
• Minimal Training Required: Implementing the GDS requires minimal training, enabling healthcare professionals to integrate it into their practice easily.
• Self-Administration Option: The GDS can be self-administered, reducing the burden on healthcare providers and allowing individuals to conveniently assess their symptoms.

GDS in Individuals with Dementia

• The GDS can effectively screen for depression in individuals with dementia who have Mini-Mental State Exam (MMSE) scores of 15 or higher.
• However, the Cornell Scale for Depression in Dementia (CSDD) has shown superior accuracy in identifying depression in individuals with dementia compared to the GDS.

Conclusion

Depression among older adults is common but often overlooked or misdiagnosed. The GDS serves as an invaluable tool in