Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-18T21:02:41.041Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of anxiety in long-term care: examination of the Geriatric Anxiety Inventory (GAI) and its short form

Published online by Cambridge University Press:  20 June 2013

Lindsay A. Gerolimatos ,
Jeffrey J. Gregg  and
Barry A. Edelstein
Lindsay A. Gerolimatos*
Affiliation:
Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
Jeffrey J. Gregg
Affiliation:
Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
Barry A. Edelstein
Affiliation:
Department of Psychology, West Virginia University, Morgantown, West Virginia, USA
*
Correspondence should be addressed to: Lindsay A. Gerolimatos, M.S., Department of Psychology, West Virginia University, 53 Campus Drive, PO Box 6040, Morgantown, WV 26506, USA. Phone: +1-304-293-8639; Fax: +1-304-293-6606. Email: [email protected].
Get access

Abstract

Background:

Accurate assessment of anxiety in later life is critical, as anxiety among older adults is associated with social and functional impairment and poorer quality of life. The Geriatric Anxiety Inventory (GAI) and the GAI–Short Form (GAI-SF) were designed to detect anxiety symptoms among community-dwelling older adults, but the usefulness of the GAI and GAI-SF in long-term care is unknown. The present study examined the psychometric properties of the GAI and GAI-SF among residents at a long-term care facility.

Methods:

Seventy-five nursing home residents completed the GAI and measures of depression, executive functioning, and adaptive functioning. The mean age of residents was 69.60 years (SD = 10.76). Psychiatric diagnoses included dementia, psychotic disorders, mood disorders, anxiety disorders, substance abuse, sleep disorders, and mental retardation.

Results:

Internal consistency of the GAI was good (α = 0.92) and the GAI-SF was adequate (α = 0.73). GAI and GAI-SF scores were moderately correlated with depression scores, and weakly correlated with adaptive functioning scores and executive functioning scores, suggesting discriminant validity. Logistic regression analyses were conducted with GAI and GAI-SF scores predicting an anxiety disorders diagnosis. Results provided support for the predictive validity of the GAI and GAI-SF. Sensitivity, specificity, and the percentage of individuals correctly classified at various cut-off scores were also calculated.

Conclusions:

Both the GAI and GAI-SF appear to be useful tools for assessing anxiety among nursing home residents with psychological disorders. The GAI-SF may be a viable replacement for the GAI as a screener for anxiety in long-term care.

Keywords

clinical assessmentlong-term careanxiety
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 9 , September 2013 , pp. 1533 - 1542
Copyright
Copyright © International Psychogeriatric Association 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ayers, C. R., Sorrell, J. T., Thorp, S. R. and Wetherell, J. (2007). Evidence-based psychological treatments for late-life anxiety. Psychology and Aging, 22, 8–17. doi:10.1037/0882-7974.22.1.8.CrossRefGoogle ScholarPubMed
Beck, J. G. and Averill, P. M. (2004). Older adults. In Heimberg, R. G., Turk, C. L. and Mennin, D. S. (eds.), Generalized Anxiety Disorder: Advances in Research and Practice (pp. 409–433). New York: Guilford Press.Google Scholar
Beekman, A. T. F., de Beurs, E., van Balkom, A. J. L. M., Deeg, D. J. H., van Dyck, R. and van Tilburg, W. (2000). Anxiety and depression in later life: co-occurrence and communality of risk factors. American Journal of Psychiatry, 157, 89–95.CrossRefGoogle ScholarPubMed
Boddice, G., Pachana, N. A. and Byrne, G. J. (2008). The clinical utility of the Geriatric Anxiety Inventory in older adults with cognitive impairment. Nursing Older People, 20, 36–39.CrossRefGoogle ScholarPubMed
Boey, K. W. (2000). The use of the GDS-15 among the older adults in Beijing. Clinical Gerontologist, 21, 49–60. doi:10.1300/J018v21n02_05.CrossRefGoogle Scholar
Braga, R. J., Petrides, G. and Figueira, I. (2004). Anxiety disorders in schizophrenia. Comprehensive Psychiatry, 45, 460–468. doi:10.1016/j.comppsych.2004.07.009.CrossRefGoogle ScholarPubMed
Brenes, G. A.et al. (2005). The influence of anxiety on the progression of disability. Journal of the American Geriatrics Society, 53, 34–39. doi:10.1111/j.1532-5415.2005.53007.x.CrossRefGoogle ScholarPubMed
Bryant, C., Jackson, H. and Ames, D. (2008). The prevalence of anxiety in older adults: methodological issues and a review of the literature. Journal of Affective Disorders, 109, 233–250. doi:10.1016/j.jad.2007.11.008.CrossRefGoogle Scholar
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults. Archives of General Psychiatry, 67, 489–496. doi:10.1001/archgenpsychiatry.2010.35.CrossRefGoogle ScholarPubMed
Byrne, G. J. and Pachana, N. A. (2011). Development and validation of a short form of the Geriatric Anxiety Inventory – the GAI-SF. International Psychogeriatrics, 23, 125–131. doi:10.1017/S1041610210001237.CrossRefGoogle Scholar
Byrne, G. J., Pachana, N. A., Goncalves, D. C., Arnold, E., King, R. and Khoo, S. K. (2010). Psychometric properties and health correlates of the Geriatric Anxiety Inventory in Australian community-residing older women. Aging and Mental Health, 14, 247–254. doi:10.1080/13607861003587628.CrossRefGoogle ScholarPubMed
Campbell, D. T. and Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait–multimethod matrix. Psychological Bulletin, 56, 81–105. doi:10.1037/h0046016.CrossRefGoogle ScholarPubMed
Carmines, E. G. and Zeller, R. A. (1979). Reliability and Validity Assessment. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
D’Ath, P., Katona, P., Mullan, E., Evans, S. and Katona, C. (1994). Screening, detection and management of depression in elderly primary care attenders: the acceptability and performance of the 15 item Geriatric Depression Scale (GDS-15) and the development of short versions. Family Practice, 11, 260–266. doi:10.1093/fampra/11.3.260.CrossRefGoogle Scholar
DeVellis, R. F. (2012). Scale development: Theory and applications, 3rd edn.Thousand Oaks, CA: Sage.Google Scholar
Diefenbach, G. J.et al. (2003). ‘Minor GAD’: characteristics of subsyndromal GAD in older adults. Behaviour Research and Therapy, 41, 481–487. doi:10.1016/S0005-7967(02)00130-4.CrossRefGoogle ScholarPubMed
Diefenbach, G. J., Tolin, D. F. and Gilliam, C. M. (2012). Impairments in life quality among clients in geriatric home care: associations with depressive and anxiety symptoms. International Journal of Geriatric Psychiatry, 27, 828–835. doi:10.1002/gps.2791.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S, E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198. doi:10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Friedman, B., Heisel, M. J. and Delavan, R. L. (2005). Psychometric properties of the 15-item Geriatric Depression Scale in functionally impaired, cognitively intact, community-dwelling elderly primary care patients. Journal of the American Geriatrics Society, 53, 1570–1576. doi:10.1111/j.1532-5415.2005.53461.x.CrossRefGoogle ScholarPubMed
Goldberg, D., Bridges, K., Duncan-Jones, P. and Grayson, D. (1988). Detecting anxiety and depression in general medical settings. British Medical Journal, 297, 897–899.CrossRefGoogle ScholarPubMed
Grabowski, D. G., Aschbrenner, K. A., Feng, Z. and Mor, V. (2009). Mental illness in nursing homes: variations across states. Health Affairs, 28, 689–700. doi:10.1377/hlthaff.28.3.689.CrossRefGoogle ScholarPubMed
Gum, A. M., King-Kallimanis, B. and Kohn, R. (2009). Prevalence of mood, anxiety, and substance-abuse disorders for older Americans in the national comorbidity survey-replication. The American Journal of Geriatric Psychiatry, 17, 769–781. doi:10.1097/JGP.0b013e3181ad4f5a.CrossRefGoogle ScholarPubMed
Herrmann, N.et al. (1996). A validation study of the Geriatric Depression Scale Short Form. International Journal of Geriatric Psychiatry, 11, 457–460. doi:10.1002/(SICI)1099-1166(199605)11:5<457::AID-GPS325>3.0.CO;2-2.3.0.CO;2-2>CrossRefGoogle Scholar
Hersen, M. and Van Hasselt, V. B. (1992). Behavioral assessment and treatment of anxiety in the elderly. Clinical Psychology Review, 12, 619–640. doi:10.1016/0272-7358(92)90135-U.CrossRefGoogle Scholar
Hodgson, N., Freedman, V. A., Granger, D. A. and Emo, A. (2004). Biobehavioral correlates of relocation in the frail elderly: salivary cortisol, affect, and cognitive function. Journal of the American Geriatrics Society, 52, 1856–1862. doi:10.1111/j.1532-5415.2004.52505.x.CrossRefGoogle ScholarPubMed
Kerby, D. S., Wentworth, R. and Cotton, P. D. (1989). Measuring adaptive behavior in elderly developmentally disabled clients. The Journal of Applied Gerontology, 8, 261–267. doi:10.1177/073346488900800212.CrossRefGoogle Scholar
Kogan, J. N., Edelstein, B. A. and McKee, D. R. (2000). Assessment of anxiety in older adults: current status. Journal of Anxiety Disorders, 14, 109–132. doi:10.1016/S0887-6185(99)00044-4.CrossRefGoogle ScholarPubMed
Lenze, E. J.et al. (2005). Somatic symptoms in late-life anxiety: treatment issues. Journal of Geriatric Psychiatry and Neurology, 18, 89–96. doi:10.1177/0891988705276251.CrossRefGoogle ScholarPubMed
Lesher, E. L. and Berryhill, J. S. (1994). Validation of the Geriatric Depression Rating Scale among inpatients. Journal of Clinical Psychology, 50, 256–260.3.0.CO;2-E>CrossRefGoogle Scholar
Marc, L. G., Raue, P. J. and Bruce, M. L. (2008). Screening performance of the Geriatric Depression Scale (GDS-15) in a diverse elderly home care population. American Journal of Geriatric Psychiatry, 16, 914–921. doi:10.1097/JGP.0b013e318186bd67.CrossRefGoogle Scholar
Messick, S. (1995). Validity of psychological assessment: validation of inferences from persons’ responses and performances as scientific inquiry into score meaning. American Psychologist, 50, 741–749.CrossRefGoogle Scholar
Montgomery, S. A. and Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382–389. doi:10.1192/bjp.134.4.382.CrossRefGoogle ScholarPubMed
Nihira, K., Foster, R., Shellhaas, M. and Leland, H. (1974). AAMD Adaptive Behavior Scale. Washington, DC: American Association on Mental Deficiency.Google Scholar
Pachana, N. A. and Byrne, G. J. (2012). The Geriatric Anxiety Inventory: international use and future directions. Australian Psychologist, 47, 33–38. doi:10.1111/j.1742-9544.2011.00052.x.CrossRefGoogle Scholar
Pachana, N., Byrne, G., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103–114. doi:10.1017/S1041610206003504.CrossRefGoogle ScholarPubMed
Pierce, P. S. (1989). Adult Functional Adaptive Behavior Scale (AFABS): Manual of Directions. Togus, ME: Author.Google Scholar
Pomeroy, I. M., Clark, C. R. and Philp, I. (2001). The effectiveness of very short scales for depression screening in elderly medical patients. International Journal of Geriatric Psychiatry, 16, 321–326. doi:10.1002/gps.344.CrossRefGoogle ScholarPubMed
Rahman, M., Grabowski, D. C., Intrator, O., Cai, S. and Mor, V. (2012). Serious mental illness and nursing home quality of care. Health Services Research. doi:10.1111/1475-6773.12023.Google ScholarPubMed
Reynolds, C. R., Richmond, B. O. and Lowe, P. A. (2003). The Adult Manifest Anxiety Scale (AMAS): Manual. Los Angeles: Western Psychological Services.Google Scholar
Rovner, B. W., German, P. S., Broadhead, J. and Morriss, R. K. (1990). The prevalence and management of dementia and other psychiatric disorders in nursing homes. International Psychogeriatrics, 2, 13–24. doi:10.1017/S1041610290000266.CrossRefGoogle ScholarPubMed
Royall, D. R., Mahurin, R. K. and Gray, K. F. (1992). Bedside assessment of executive cognitive impairment: the executive interview. Journal of the American Geriatrics Society, 40, 1221–1226.CrossRefGoogle ScholarPubMed
Schillerstrom, J. E., Salazar, R., Regwan, H., Bonugli, R. J. and Royall, D. R. (2009). Executive function in self-neglecting adult protective services referrals compared with elder psychiatric outpatients. The American Journal of Geriatric Psychiatry, 17, 907–910. doi:10.1097/JGP.0b013e3181b4bf64.CrossRefGoogle ScholarPubMed
Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: the Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24, 709–714. doi:10.1016/j.janxdis.2010.05.002.CrossRefGoogle ScholarPubMed
Seignourel, P. J., Kunik, M. E., Snow, L., Wilson, N. and Stanley, M. (2008). Anxiety in dementia: a critical review. Clinical Psychology Review, 28, 1071–1082. doi:10.1016/j.cpr.2008.02.008.CrossRefGoogle ScholarPubMed
Sheikh, J. A. and Yesavage, J. A. (1986). Geriatric Depression Scale (GDS): recent findings and development of a shorter version. In Brink, T. L. (ed.), Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165–173). New York: Howarth Press.Google Scholar
Smalbrugge, M. M., Pot, A. M., Jongenelis, K. K., Beekman, A. F. and Eefsting, J. A. (2005). Prevalence and correlates of anxiety among nursing home patients. Journal of Affective Disorders, 88, 145–153. doi:10.1016/j.jad.2005.06.006.CrossRefGoogle ScholarPubMed
Smalbrugge, M. M., Pot, A. M., Jongenelis, L., Gundy, C. M., Beekman, A. F. and Eefsting, J. A. (2006). The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients. International Journal of Geriatric Psychiatry, 21, 325–332. doi:10.1002/gps.1466.CrossRefGoogle ScholarPubMed
Sparrow, S. S., Balla, D. A. and Cicchetti, D. V. (1984). Vineland Adaptive Behavior Scale: Interview Edition, Survey Form. Circle Pines, NM: American Guidance Service, Inc.Google Scholar
Spielberger, C. D., Gorsuch, R. R. and Luchene, R. E. (1970). The State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Spirrison, C. L. and Pierce, P. S. (1992). Psychometric characteristics of the Adult Functional Adaptive Behavior Scale (AFABS). The Gerontologist, 32, 234–239. doi:10.1093/geront/32.2.234.CrossRefGoogle ScholarPubMed
Stanley, M. A. and Novy, D. M. (2000). Cognitive-behavior therapy for generalized anxiety in late life: an evaluative overview. Journal of Anxiety Disorders, 14, 191–207. doi:10.1016/S0887-6185(99)00048-1.CrossRefGoogle ScholarPubMed
Steiner, A.et al. (1996). Measuring psychosocial aspects of well-being in older community residents: performance of four short scales. The Gerontologist, 36, 54–62. doi:10.1093/geront/36.1.54.CrossRefGoogle ScholarPubMed
Stockholm, J., Vogel, A., Gade, A. and Waldemar, G. (2005). The executive interview as a screening test for executive dysfunction in patients with mild dementia. Journal of the American Geriatrics Society, 53, 1577–1581. doi:10.1111/j.1532-5415.2005.53470.x.CrossRefGoogle Scholar
Teachman, B. A. (2006). Aging and negative affect: the rise and fall and rise of anxiety and depression symptoms. Psychology and Aging, 21, 201–207. doi:10.1037/0882-7974.21.1.201.CrossRefGoogle ScholarPubMed
Tobin, S. S. (1989). The effects of institutionalization. In Markides, K. S. and Cooper, C. L. (eds.), Aging, Stress, and Health (pp. 139–163). New York: Wiley.Google Scholar
Tolin, D. F., Robison, J. T., Gaztambide, S. and Blank, K. (2005). Anxiety disorders in older Puerto Rican primary care patients. The American Journal of Geriatric Psychiatry, 13, 150–156. doi:10.1176/appi.ajgp.13.2.150.CrossRefGoogle ScholarPubMed
Wetherell, J. L., Le Roux, H. and Gatz, M. (2003). DSM-IV criteria for generalized anxiety disorder in older adults: distinguishing the worried from the well. Psychology and Aging, 18, 622–627.CrossRefGoogle ScholarPubMed
Yesavage, J. A.et al. (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49. doi:10.1016/0022-3956(82)90033-4.CrossRefGoogle Scholar