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15 - Item Geriatric Depression Scale (GDS-15)
Availability
Please visit this website for more information about the instrument: 15 - Item Geriatric Depression Scale
Classification
Supplemental - Highly Recommended: Parkinson's Disease (PD)
Recommendations for use: Indicated for studies requiring a measure for depression in the geriatric population.
Short Description of Instrument
Background: Developed to screen for depression without notable focus on somatic symptoms. Items were geared to assess psychological symptoms and cognitive complaints associated with depression. The tool was designed with a simple Yes/No format for responses to limit resistance towards psychiatric assessments or interventions in older adults.
 
Construct measured: Depression in geriatric patients.
 
Generic vs. disease-specific: Generic
 
Means of administration: Self-report
 
Intended respondent: Patient
 
# of items: 15
30 items in the original GDS. Shorter versions (e.g., GDS-15, -10, and -4) were developed to facilitate assessment in primary care, hospital, and home settings. The GDS-15 is highly recommended for use in PD.
 
# of subscales and names of sub-scales: N/A (total score)
 
# of items per sub-scale: N/A
 
Administration time: 5 minutes
Comments/Special Instructions
Parkinson's Disease-Specific: Free, widely used, and applicable to PD populations as patients are generally geriatric. Also widely used to screen for depression among the elderly in the general population.  
 
The GDS does not ask about suicidality explicitly. GDS-15 is used by the Parkinson Foundation Centers of Excellence protocol for screening protocol.
Available in multiple languages.
Scoring and Psychometric Properties
Scoring: For all GDS versions, one point is given for each Yes or No answer indicative of depression: For GDS-15, a score > 5 points is suggestive of depression and need for a follow-up interview. Scores > 10 are typically indicative of a depressive disorder.
 
Psychometric Properties:
Feasibility: Easy to administer, quick to score. Used in clinical and community-based settings.
 
Reliability: Test-retest reliability (1 week) 0.85. Internal consistency (alpha coefficient 0.94) higher than other depression measures (Hamilton Depression Rating Scale, Zung Self-Rating Depression Scale), Split-half reliability (0.94).
 
The score representing the optimal dichotomization cutoff point for the GDS-15 was 4/5 (sensitivity 0.88, specificity 0.85). AUC for GDS-15 = 0.92, 95% confidence interval 0.87-0.93 vs DSM-IV diagnosis of depression.
 
Validity: Recent meta-analyses evaluating the pooled estimate for diagnostic accuracy across different GDS forms showed that shorter forms of GDS (GDS-15, GDS-10) had higher diagnostic accuracy compared to GDS-30. GDS-30 had 82% sensitivity, 76% specificity, and AUC-0.85; GDS-15 had 86% sensitivity, 79% specificity, and AUC=0.90; GDS10 had 87% sensitivity, 75% specificity, and AUC=0.83; GDS-4 had 74% sensitivity, 71% specificity, and AUC=0.79. (Krishnamoorthy et al., 2020)
 
Sensitivity to Change: Unknown
 
Relationships to other variables: The GDS is a valid depression screening tool in both physically healthy and physically ill elderly adults.
Rationale/Justification
Strengths: Quick, easy to use, completed by patient, does not require interview or informant, can be completed verbally or in writing; in public domain (free).
 
Weaknesses: Not validated in younger adult patient populations (normed on patients 55 and older), cut-off scores do not categorize patients into moderate range, just mild and severe.
References
Key References:
Sheikh, J.I., Yesavage, J.A. (1986). Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version.
 
In T.L. Brink (Ed.), Clinical Gerontology: A Guide to Assessment and Intervention (165-173). The Haworth Press.
 
Brink TL, Yesavage JA, Lum O, Heersema P, Adey MB, Rose TL. Screening tests for geriatric depression. Clin Gerontol. 1982;1(1):37-44.
 
Additional References:
Goodarzi Z, Mrklas KJ, Roberts DJ, Jette N, Pringsheim T, Holroyd-Leduc J. Detecting depression in Parkinson disease: A systematic review and meta-analysis. Neurology. 2016 Jul 26;87(4):426-37.
 
Krishnamoorthy Y, Rajaa S, Rehman T. Diagnostic accuracy of various forms of geriatric depression scale for screening of depression among older adults: Systematic review and meta-analysis. Arch Gerontol Geriatr. 2020 Mar-Apr;87:104002.
 
Sheikh JI, Yesavage JA, Brooks JO 3rd, Friedman L, Gratzinger P, Hill RD, Zadeik A, Crook T. Proposed factor structure of the Geriatric Depression Scale. Int Psychogeriatr. 1991 Spring;3(1):23-8.
 
Weintraub D, Oehlberg KA, Katz IR, Stern MB. Test characteristics of the 15-item geriatric depression scale and Hamilton depression rating scale in Parkinson disease. Am J Geriatr Psychiatry. 2006;14(2):169-175.
Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-1983;17(1):37-49.
 
Parkinson's Disease-Specific References:
Calleo J, Williams JR, Amspoker AB, Swearingen L, Hirsch ES, Anderson K, Goldstein SR, Grill S, Lehmann S, Little JT, Margolis RL, Palanci J, Pontone GM, Weiss H, Rabins P, Marsh L. Application of depression rating scales in patients with Parkinson's disease with and without co-Occurring anxiety. J Parkinsons Dis. 2013;3(4):603-8.
 
Williams JR, Hirsch ES, Anderson K, Bush AL, Goldstein SR, Grill S, Lehmann S, Little JT, Margolis RL, Palanci J, Pontone G, Weiss H, Rabins P, Marsh L. A comparison of nine scales to detect depression in Parkinson disease: which scale to use? Neurology. 2012 Mar 27;78(13):998-1006.
 
Document last updated August 2022