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    Geriatric Depression Scale Content and Scoring

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    Geriatric Depression Scale Content and Scoring

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    Key Takeaways

    • The Geriatric Depression Scale (GDS) is a tool that helps identify depression symptoms in elderly adults.
    • The GDS-15 with 15 questions is a reliable form and a score over 5 suggests depression.
    • The GDS is free to use and can be self-administered without much training.

    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.

    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.

    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.

    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.

    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.

    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.

    Forms

    The GDS is available in three forms:

    • The long-form GDS (GDS-30), which consists of 30 questions
    • The short form (GDS-15), which has 15 questions
    • Four- and five-item versions, the accuracy of which is inconclusive

    Questions on the Scale

    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

    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.

    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.

    Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

    1. Blazer DG. Depression in late life: Review and commentary. FOC. 2009;7(1):118-136. doi:10.1176/foc.7.1.foc118

    2. Lach HW, Chang YP, Edwards D. Can older adults with dementia accurately report depression using brief forms? Reliability and validity of the Geriatric Depression Scale. J Gerontol Nurs. 2010;36(5):30-7. doi:10.3928/00989134-20100303-01

    3. Conradsson M, Rosendahl E, Littbrand H, Gustafson Y, Olofsson B, Lövheim H. Usefulness of the Geriatric Depression Scale 15-item version among very old people with and without cognitive impairment. Aging Ment Health. 2013;17(5):638-645. doi:10.1080/13607863.2012.758231

    4. Rule BG, Harvey HZ, Dobbs AR. Reliability of the geriatric depression scale for younger adults. Clinical Gerontologist. 1990;9(2):37-43. doi:10.1300/J018v09n02_05

    5. Usefulness of the 15-item geriatric depression scale (GDS-15) for classifying minor and major depressive disorders among community-dwelling elders. Journal of Affective Disorders. 2019;259:370-375. doi:10.1016/j.jad.2019.08.053

    6. Brañez-Condorena A, Soriano-Moreno DR, Navarro-Flores A, Solis-Chimoy B, Diaz-Barrera ME, Taype-Rondan A. Accuracy of the Geriatric Depression Scale (Gds)-4 and GDS-5 for the screening of depression among older adults: A systematic review and meta-analysis. PLOS ONE. 2021;16(7):e0253899. doi:10.1371/journal.pone.0253899

    7. Jongenelis K, Pot AM, Eisses AM, et al. Diagnostic accuracy of the original 30-item and shortened versions of the Geriatric Depression Scale in nursing home patients. Int J Geriatr Psychiatry. 2005;20(11):1067-74. doi:10.1002/gps.1398

    8. Which of the Cornell Scale for Depression in Dementia or the Geriatric Depression Scale is more useful to screen for depression in older adults? Asian Journal of Psychiatry. 2022;72:103147. doi:10.1016/j.ajp.2022.103147

    Additional Reading

    By Esther Heerema, MSW

    Esther Heerema, MSW, shares practical tips gained from working with hundreds of people whose lives are touched by Alzheimer’s disease and other kinds of dementia. 

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