Psychometric properties and diagnostic accuracy of the short form of the geriatric anxiety scale (GAS-10)

Abstract

Background Anxious symptoms have a negative impact on different aspects of the elderly’s quality of life, ranging from the adoption of unhealthy lifestyle behaviours to an increased functional impairment and a greater physical disability. Different brief assessment instruments have been developed as efficacy measures of geriatric anxiety in order to overcome psychometric weaknesses of its long form. Among these, the 10-item Geriatric Anxiety Scale (GAS-10) showed strong psychometric properties in community-dwelling samples. However, its diagnostic accuracy is still unexplored, as well as its discriminative power in clinical samples. Methods In the present study, we explored the psychometric performance of the GAS-10 in the elderly through Item Response Theory in a sample of 1200 Italian community-dwelling middle-aged and elderly adults (53.8% males, mean age = 65.21 ± 9.19 years). Concurrent validity, as well as diagnostic accuracy, was examined in a non-clinical sample (N = 229; 46.72% males) and clinical sample composed of 35 elderly outpatients (74.28% females) with Generalized Anxiety Disorder (GAD). Results The GAS-10 displayed good internal construct validity, with unidimensional structure and no local dependency, good accuracy, and no signs of Differential Item Functioning (DIF) or measurement bias due to gender, but negligible due to the age. Differences in concurrent validity and diagnostic accuracy among the long form version of the GAS and the GAS-10 were not found significant. The GAS-10 may be more useful than the longer versions in many clinical and research applications, when time constraints or fatigue are issues. Conclusion Using the ROC curve, the GAS-10 showed good discriminant validity in categorizing outpatients with GAD disorder, and high anxiety symptoms as measured by the GAS-SF cut-off. The stable cut-off point provided could enhance the clinical usefulness of the GAS-10, which seems to be a promising valid and reliable tool for maximize diagnostic accuracy of geriatric anxiety symptoms.

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“…Frailty scores were measured using the Fit-Frailty Assessment & Management Application (pre-frail scores 0.18 to 0.24 and frail >0.24) [ 27 ], activities of daily living with the Nottingham Extended Activities of Daily Living Scale [ 28 ], and health-related quality of life using the EuroQol 5-Dimension 5-Level (EQ-5D-5L) questionnaire [ 29 ]. We assessed depression scores using the Geriatric Depression Scale [ 30 ] and anxiety using the Geriatric Anxiety Scale (GAS-10) [ 31 ]. Demographic characteristics were collected using PROGRESS (Place of residence, Race/ethnicity, Occupation, Gender and sex, Religion, Education, Socioeconomic status, and Social capital) [ 32 ].…”

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“…Self-reported information on driving status, mobility issues, depression (43), stress (44), cognitive functioning (45), subjective wellbeing (46), anxiety (47), physical activity (48), sleep pattern (49), and emotional loneliness (50) will be collected.…”

Development and Validation of a Short Form of the Geriatric Anxiety Scale (GAS-12) among Italian Older Adults

“…Mueller et al (2015) provided results for item selection and age and gender differences for the original GAS-10. Carlucci et al (2021) who examined associations between the GAS-10 and other psychological questionnaires, found strong, positive correlations with measures of anxiety and depression, and moderate, negative associations with mental health components of Quality of Life (QoL).…”