Answer: The geriatric depression scale (GDS) is a self-report questionnaire used to assess depression in community-dwelling older patients.
Geriatric patients will often experience changes in mood that can result in sadness or periods of "feeling blue." However, severe and prolonged feelings of worthlessness and despair are not normal. The incidence of depression is generally higher among the elderly, reaching as high as 13% among people older than 80 years old. For those patients living in nursing homes, the rate of depression can be as high as 50% in their first year as they adjust to their new living environment. Suicide has a high prevalence among the elderly, and quickly and accurately diagnosing depression is a valuable way to minimize the loss of life and improve the quality of life of patients and their families.
The geriatric depression scale (GDS) is a short 30 question assessment test that is used to diagnose depression. It was first developed in 1983 by Yesavage at al. The questions are all yes or no, and asks about the patients experience over the past week. It is not a substitute for a complete clinical diagnosis, but it has almost 90% specificity and selectivity for detecting depression. Depressed patients score more yes than no answers.
A shortened, 15-item scale called the geriatric depression scale short form (GDS-SF) has also been developed for use in assessing patients who may have difficulty concentrating for the full 30 item questionnaire.
Items on the geriatric depression scale
1. Are you basically satisfied with your life?
2. Have you dropped many of your activities and interests?
3. Do you feel that your life is empty?
4. Do you often get bored?
5. Are you hopeful about the future?
6. Are you bothered by thoughts you can't get out of your head?
7. Are you in good spirits most of the time?
8. Are you afraid that something bad is going to happen to you?
9. Do you feel happy most of the time?
10. Do you often feel helpless?
11. Do you often get restless and fidgety?
12. Do you prefer to stay at home, rather than going out and doing new things?
13. Do you frequently worry about the future?
14. Do you feel you have more problems with memory than most?
15 Do you think it is wonderful to be alive now?
16 Do you often feel downhearted and blue?
17 Do you feel pretty worthless the way you are now?
18 Do you worry a lot about the past?
19 Do you find life very exciting?
20 Is it hard for you to get started on new projects?
21 Do you feel full of energy?
22 Do you feel that your situation is hopeless?
23 Do you think that most people are better off than you are?
24 Do you frequently get upset over little things?
25 Do you frequently feel like crying?
26 Do you have trouble concentrating?
27 Do you enjoy getting up in the morning?
28 Do you prefer to avoid social gatherings?
29 Is it easy for you to make decisions?
30 Is your mind as clear as it used to be?
One major advantage of the GDS as an assessment tool is that it probes specifically for psychiatric concerns rather than somatic concerns.
Scoring the geriatric depression scale
For each yes answer, add 1 to the score. Most normal patients will score between a 0 and 9. Patients who score between 10 and 19 are considered "mildly depressed", and patients with scores above 20 are considered "severely depressed".