The Hartford Institute: Geriatric Depression Scale in Nursing Care

This document presents the Geriatric Depression Scale (GDS), a crucial tool for assessing depression in older adults. Developed by Yesavage et al., the GDS is a brief questionnaire designed to identify depressive symptoms in various settings, including community, acute care, and long-term care. The document highlights the GDS's strengths, such as its ease of use and established validity and reliability, while acknowledging its limitations, including its role as a screening tool rather than a diagnostic interview. It provides detailed instructions on scoring and interpreting the GDS, differentiating between normal, mild, moderate, and severe depression levels. Furthermore, the document emphasizes the importance of prompt intervention and treatment for depression, suggesting the GDS as a valuable tool for monitoring patients over time and guiding further psychological assessment when necessary. The resource includes the GDS Short Form and references to related materials and websites, underscoring its value for nursing professionals and students seeking to improve their geriatric care practices.

From The Hartford Institute for Geriatric Nursing, New York University Rory Meyers College
Best Practices in Nursing
Care to Older Adults
general assessment series
Issue Number 4, Revised 2019 Editor-in-Chief: Sherry A. Gre
New York University Rory Meyers College of N
The Geriatric Depression Scale (GDS)
By: Sherry A. Greenberg, PhD, RN, GNP-BC, Hartford Institute for Geriatric
New York University Rory Meyers College of Nursing
WHY: Depression is common in late life, affecting nearly 5 million of the 31 million Americans aged 65 and older with
depressive symptoms reaching 13% in older adults aged 80 and older (Blazer, 2009). Major depression is reported in 5
older adults, up to 54% in the first year living in a nursing home, and 10-12% of hospitalized older adults (Blazer, 200
Depression is more common in those with multiple chronic conditions.
Depression is not a natural part of aging. Depression is often reversible with prompt recognition and appropriate trea
untreated, depression may result in the onset of physical, cognitive, functional, and social impairment, as well as decr
recovery from medical illness and surgery, increased health care utilization, and suicide.
BEST TOOL: While there are many instruments available to measure depression, the Geriatric Depression Scale (GDS
et al., has been tested and used extensively with the older population. The GDS Long Form is a brief, 30-item question
are asked to respond by answering yes or no in reference to how they felt over the past week. A Short Form GDS cons
developed in 1986. Questions from the Long Form GDS which had the highest correlation with depressive symptoms i
selected for the short version. Of the 15 items, 10 indicated the presence of depression when answered positively, w
1, 5, 7, 11, 13) indicated depression when answered negatively. Scores of 0-4 are considered normal, depending on a
5-8 indicate mild depression; 9-11 indicate moderate depression; and 12-15 indicate severe depression.
The Short Form is more easily used by physically ill and mildly to moderately demented patients who have short attent
fatigued. It takes about 5 to 7 minutes to complete.
TARGET POPULATION: The GDS may be used with healthy, medically ill and mild to moderately cognitively impaire
extensively used in community, acute care, and long-term care settings.
VALIDITY AND RELIABILITY: The GDS was found to have a 92% sensitivity and an 89% specificity when evaluated
The validity and reliability of the tool have been supported through both clinical practice and research. In a validatio
Short Forms of the GDS for self-rating of symptoms of depression, both were successful in differentiating depressed
with a high correlation (r = 0.84, p < .001) (Sheikh & Yesavage, 1986).
STRENGTHS AND LIMITATIONS: The GDS is not a substitute for a diagnostic interview by mental health professio
screening tool in the clinical setting to facilitate assessment of depression in older adults especially when baseline mea
subsequent scores. It does not assess for suicidality.
FOLLOW-UP: The presence of depression warrants prompt intervention and treatment. The GDS may be used to mo
in all clinical settings. Any positive score above 5 on the GDS Short Form should prompt an in-depth psychological ass
suicidality.
MORE ON THE TOPIC:
Best practice information on care of older adults: https://consultgeri.org.
The Stanford/VA/NIA Aging Clinical Resource Center (ACRC) website. Retrieved June 20, 2018, from
http://www.stanford.edu/~yesavage/ACRC.html. Information on the GDS. Retrieved June 20, 2018, from
http://www.stanford.edu/~yesavage/GDS.html.
Blazer, D.G. (2009). Depression in late life: Review and commentary. FOCUS, 7(1), 118-136.
Koenig, H.G., Meador, K.G., Cohen, J.J., & Blazer, D.G. (1988). Self-rated depression scales and screening for major de
hospitalized patient with medical illness. JAGS, 36, 699-706.
McKenzie, G. L., & Harvath, T. A. (2016). Late-life depression. In M. Boltz, E. Capezuti, T. Fulmer, & D. Zwicker (Eds
Ed.), Evidence-based geriatric nursing protocols for best practice (5th ed., pp. 211-232). NY: Springer Publishing C
Sheikh, J.I., & Yesavage, J.A. (1986). Geriatric Depression Scale (GDS). Recent evidence and development of a shorter
Clinical Gerontology: A Guide to Assessment and Intervention (pp. 165-173). NY: The Haworth Press, Inc.
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M.B., & Leirer, V.O. (1983). Development and validat
screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37-49.
Permission is hereby granted to reproduce, post, download, and/or distribute, this material in its entirety for not-for-profit educational purpos
The Hartford Institute for Geriatric Nursing, New York University, Rory Meyers College of Nursing is cited as the source. This material may be downlo
format, including PDA format. Available on the internet at www.ConsultGeri.org. E-mail notification of usage to: nursing.hign@

Best Practices in Nursing
Care to Older Adults
A series provided by The Hartford Institute for Geriatric Nursing,
NYU Rory Meyers College of Nursing
EMAIL: [e-mail]ITE: www.hign.org
CLINICALNURSINGWEBSITE: www.ConsultGeri.org
general assessment series
Geriatric Depression Scale: Short Form
Choose the best answer for how you have felt over the past week:
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
Answers in bold indicate depression. Score 1 point for each bolded answer.
A score > 5 points is suggestive of depression.
A score ≥ 10 points is almost always indicative of depression.
A score > 5 points should warrant a follow-up comprehensive assessment.
Source: http://www.stanford.edu/~yesavage/GDS.html
This scale is in the public domain.
The Hartford Institute for Geriatric Nursing would like to acknowledge the original author of this Try This
RN, CS, FAAN, who made significant contributions to the field of geropsychiatric nursing and passed away