The Geriatric Depression Scale (GDS) is a screening tool used to identify symptoms of depression in elderly adults. Originally developed by J.A. Yesavage and colleagues in 1982, the GDS is a self-report instrument that uses a “yes/no” format. It consists of questions that assess a person’s level of enjoyment, interest, social interactions, and more.
Uses
The GDS is frequently used in acute, long-term, and community settings, often part of a comprehensive geriatric assessment. It’s appropriate for healthy as well as medically ill adults and those with mild to moderate cognitive impairments.
Some sources estimate the incidence of depression among the elderly who live in the community at 8-15%. Among those who entered a nursing home in the prior year, that figure rises to greater than half.
Although a depression diagnosis should not be based on GDS results alone, it’s often included in a diagnostic assessment because of its established reliability and validity.
The GDS differs from depression screening instruments used in younger populations because some somatic symptoms—such as weight loss, pessimism about the future, and sleep disturbances—can be related to aging itself. For this reason, the GDS focuses specifically on psychiatric rather than somatic symptoms.
Although the GDS is used primarily for the elderly, evidence indicates that it could be a reliable screening instrument in people as young as 40.
Forms
The GDS is available in three forms:
Recent research indicates that the GDS-15 is useful in distinguishing between normal, minor depressive disorder (MnDD) and major depressive disorder (MDD) in elderly people.
- The long-form GDS (GDS-30), which consists of 30 questionsThe short form (GDS-15), which has 15 questionsFour- and five-item versions, the accuracy of which is inconclusive
Scoring
Each answer that indicates depression scores one point. For example, in the above questions, one point would be given if the person answered “no” for the first question and “yes” for the second. The answer that could indicate depression is typically underlined or bolded to indicate the responses for which a point is given. Scores for the GDS-15 range from 0 to 15: The higher the score, the more severe the depression is likely to be.
Questions on the Scale
Choose the best answer for how you have felt over the past week:
The GDS -15 is scored as follows:
5 Points: suggests depression and should be followed by a comprehensive assessment≥10 Points: almost always indicates depression<5 Points: depression not likely
Cost, Training, and Accuracy
Because the development of the scale was funded in part by the U.S. government, the GDS is considered public domain and is free to use. It requires very little training to administer and, in fact, can be self-administered. The GDS has been translated into several different languages and is available as a mobile phone app.
Using the GDS for People With Dementia
In addition to accurately identifying depression in people with intact cognition, the GDS can a useful screening tool for people whose Mini-Mental State Exam (a questionnaire that is used to measure cognitive impairment) scores were at 15 or above.
However, a study comparing the GSD with the Cornell Scale for Depression in Dementia (CSDD) concluded that the GSD is accurate in older adults without dementia, and the CSDD tended to be more accurate for those with dementia.
A Word From Verywell
Depression in the elderly is very common, but it isn’t inevitable. If you or someone you know is showing signs of depression, help is available. The GDS is often the starting point for practitioners, who can then develop an appropriate and effective treatment plan.