Tool and Resource Evaluation Template

Adapted by NARI from an evaluation template created by Melbourne Health.

Some questions may not be applicable to every tool and resource.
Name and purpose

Name of the resource: Geriatric Depression Scale (15 items and 5/15 items)
Author(s) of the resource: JA Yesavage and TL Brink.
Please state why the resource was developed and what gap it proposes to fill:
The GDS is unique from other depression scales as it was specifically developed for use with older people,
60 years and above, and it contains fewer somatic items. The GDS is easily used by physically ill older
people who have short attention spans and/or feel easily fatigued, more so than other scales. This is partly
because of its simple yes/no format, making comprehension easier than instruments that present fourchoice answers. It has been extensively used in community, acute and long-term care settings.

Target audience
(the tool is to be
used by)

The 15-item GDS is the instrument of choice due to its psychometric properties. However, the GDS 5/15
may be utilised in faster paced settings, such as the emergency department or acute hospital ward. In the
GDS 5/15, 5 screening questions are initially asked. If the GDS score is 2 or more then the remaining 10
questions are asked. This newer two-tiered instrument was developed due to concern regarding an
increase in false positives (i.e. people identified who were not depressed) on the GDS 5 compared with the
15-item GDS. Hoyl et al. (1999) and Rinaldi et al. (2003) report comparable psychometric properties for the
GDS 5 and 15.
Please check all that apply:
Health service users

Carers

Medical staff

Nursing staff

Any member of an interdisciplinary team

Medical specialist, please specify:

Specific allied health staff, please specify:
Other, please specify:
Target
population/setting
(to be used on/in)

Is the resource targeted for a specific setting? Please check all that apply:
Emergency Department

Inpatient acute

Inpatient subacute

Ambulatory

Other, please specify:

For which particular health service users would you use this resource (e.g. a person with suspected
cognitive impairment)?
An older person who is generally cognitively intact, with suspected depression.
Structure of tool

Website

Education package

Video

Pamphlet

Assessment tool

Screening tool

Methodology

Resource guide

Awareness raising resource (posters etc.)

Other, please specify:

Please state the size of the resource (e.g. number of pages, minutes to read): One page
Availability and
cost of tool

Is the resource readily available?

Yes

No

Unknown

Not applicable

Is there a cost for the resource?

Yes

No

Unknown

Not applicable

Please state how to get the resource: These tools are provided in the toolkit. They are also available on
the internet at:
http://www.bcbsga.com/provider/noapplication/plansbenefits/diseasemgmt/notertiary/pw_ad050083.pdf
http://www.stanford.edu/%7Eyesavage/GDS.html Note that for GDS-15 the cut off of 6 is recommended,
not 5 as indicated.
GDS 5/15: http://www.uth.tmc.edu/schools/med/imed/residency/chiefscorner/Documents/Articles/Geriatrics/
Geriatrics_depression_scale.pdf
Applicability to
rural settings and
culturally and
linguistically
diverse
populations

Is the resource suitable for use in rural health services (e.g. the necessary staff are usually available
Yes
No
Unknown
Not applicable
in rural settings)?
Is the resource available in different languages?
Yes
No
Unknown
Not applicable
On the web: http://www.stanford.edu/~yesavage/GDS.html
Is the content appropriate for different cultural groups?
Yes
No
Unknown
Not applicable

Person-centred
principles

Does the resource adhere to/promote person-centred health care?

Training
requirements

Is additional training necessary to use the resource?

Yes

Yes

No

No

Unknown

Unknown

Not applicable

Not applicable

If applicable, please state how extensive any training is, and what resources are required:
Training requirements are not extensive. It is a reasonably simple tool that takes a short amount of time to
ensure familiarity with questions and scoring and with a little practice (e.g. on fellow clinicians) to develop
ease with administration. To assist in this process a video demonstrating the use of the GDS can be found
on the web: go to http://www.nursingcenter.com/TryThis/Survey.asp?Ep=2&Ch=0
The most difficult part of the administration, for clinicians who have not worked in mental health and are not
used to discussing psychological conditions, is the level of discomfort experienced in discussing this topic.
Developing a standard introduction and conclusion, as demonstrated in the video, may assist with this.
Administration
details

How long does the resource take to use?

0-5 mins

5-15 mins

15-25mins

25mins +

Can the resource be used as a standalone, or must it be used in conjunction with other tools,
resources, and procedures?
Standalone
Must be used with other resources, please specify: Cognitive screen required to ensure patient does
not have a cognitive impairment that precludes them from understanding and responding to the questions in
the scale (e.g. MMSE=15+)
Can be used with other tools, please specify:
Data collection and
analysis

Are additional resources required to collect and analyse data from the resource?
Yes

No

Unknown

Not applicable

If applicable, please state any special resources required (e.g. computer software):
Sensitivity and
specificity

Sensitivity is the proportion of people that will be correctly identified by the tool.
Specificity is the probability that an individual who does not have the condition being tested for will
be correctly identified as negative.
Has the sensitivity and specificity of the resource been reported?
Yes
No
Unknown
Not applicable
If applicable, please state what has been reported:
GDS 15: Sensitivity ranges from 79%-100% and specificity from 67%-80% (e.g. Kurlowicz & Greenberg,
2007; Friedman et al., 2005). There is debate as to which cut off score gives the best specificity and
sensitivity (i.e. 5 or 6), but 6 is recommended, as it is associated with higher sensitivity.
GDS 5: Sensitivity ranges from 89%-98% and specificity ranges from 73%-85% (e.g. Rinaldi et al. 2003,
Weeks et al., 2003).

Face Validity

Does the resource appear to meet the intended purpose?

Yes
No
Unknown
Not applicable

Reliability

Reliability is the extent to which the tools measurements remain consistent over repeated tests of
the same subject under identical conditions. Inter-rater reliability measures whether independent
assessors will give similar scores under similar conditions.
Has the reliability of the resource been reported?
Yes
No
Unknown
Not applicable
If applicable, please state what has been reported:
GDS15: Reliability coefficient was 0.81 (Almeida & Almeida, 1999) and the inter-rater reliability was 0.85
(Nguyen et al., 2006).
GDS 5 : Reliability coefficient was 0.84 and interrater reliability was 0.88 (Rinaldi et al. 2003).

Strengths

What are the strengths of the resource? Is the resource easy to understand and use? Are
instructions provided on how to use the resource? Is the resource visually well presented (images,
colour, font type/ size)? Does the resource use older friendly terminology (where relevant), avoiding
jargon?
Please state any other known strengths, using dot points:

A major strength of the GDS is its ease of administration and scoring.

The simple yes/no format assists in making the scale easy to understand, decreases confusion
and perseveration (i.e. getting stuck repeating the same response).

The GDS has also placed less emphasis on somatic complaints which are common in the elderly

Limitations

with complex medical presentations.

The GDS maximises acceptability to older people who have been found to react negatively to
items regarding sexual interest or suicidal ideation which are on general depression scales.

What are the limitations of the tool/resource? Is the tool/resource difficult to understand and use?
Are instructions provided on how to use the tool/resource? Is the tool/resource poorly presented
(images, colour, font type/ size)? Does the tool/resource use difficult to understand jargon?
Please state any other known limitations, using dot points:

Not a substitute for a diagnostic interview by mental health professionals.

Does not assess suicidality.

Questionable accuracy when used to detect minor depression (Lyness et al., 1997).
Original design was self-report, which can reduce the sensitivity and specificity. It should be
implemented as an interviewer administered tool.

References and
further reading

Supporting references and associated reading.

Almeida, O.P. and Almeida, S.A. (1999). Short versions of the geriatric depression scale: a study of their
validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV
International Journal of Geriatric Psychiatry. 14(10): 858 865.
Brink TL, Yesavage JA, Lum O, Heersema P, Adey MB, Rose TL: Screening tests for geriatric depression.
Clinical Gerontologist 1: 37-44, 1982.
Chattat, R., Ellena, L., Cucinotta, D., Savorani, G., & Mucciarelli, G. (2001) A study on the validity of
different short versions of the geriatric depression scale. Archives of Gerontology and Geriatrics, suppl.7,
81-86.
Cwikel, J & Richie, K 1988, The short GDS: evaluation in a heterogeneous, multilingual population,
Clinical Gerontology, vol. 8, pp. 63-71.
Friedman, B., Heisel, M.J. & Delavan, R.L. (2005) Psychometric properties of the 15-item geriatric
depression scale in functionally impaired, cognitively intact, community-dwelling elderly primary care
patients. Journal of the American Geriatric Society (JAGS), 53(9), pp1570-76.
Goring, H, Baldwin, R, Marriott, A, Pratt, H, & Roberts, C. Validation of short screening tests for depression
and cognitive impairment in older medically ill inpatients. International Journal of Geriatric Psychiatry
2004;19:465-71.
Herrmann, N., Mittmann, N., Silver, L.L. Shulman, K.I., Busto, U.A., Shera, N.H. & Naranjo, C.A. (1998) A
validation study of the Geriatric Depression Scale short form. International Journal of Geriatric Psychiatry,
11(5), pp457-460.
Hoyl, M.T, Alessi, C.A., Harker, J.O., Josephson, K. R., Pietruszka, F.M., Koelfgen, M., Mervis, J.R., Fitten,
L.J., and Rubenstein, L.Z. (1999) Development and testing of a five-item version of the Geriatric
Depression Scale. Journal of the American Geriatrics Society, 47 (7): 873-878.
Kurlowicz,L and Greenberg,S.A (2007) The Geriatric Depression Scale (GDS). Try This: Best Practices in
Nursing Care to Older Adults. Issue 4.
Lyness, J.M., Noel, T.K., Cox, C., King, D.a., Conwell, Y. and Caine. E.D. (1997) Screening for depression
in elderly primary care patients. A comparison of the Center for Epidemiologic Studies-Depression Scale
and the Geriatric Depression Scale. Archives of Internal Medicine. Volume 157, 4: 449-454.
Nguyen, H. V. Inderjeeth, C. A. Tang, E. Barnabas, L. Merriam, M. (2006) Screening for depression in
hospitalised and community-dwelling elderly: the use of the 4-item, 5-item and 15-item geriatric depression
scales. Australasian Journal of the Ageing. 25 (4): 204-208
Rinaldi, P.;Mecocci, P.; Benedetti, C.;Ercolani, S.; Bregnocchi, M.;Menculini, G.;Catani, M.;Senin,
.
.
U ;Cherubini, A. (2003) Validation of the Five-Item Geriatric Depression Scale in Elderly Subjects in Three
Different Settings Journal of the American Geriatrics Society, Volume 51,Number 5, pp. 694-698(5).
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 (pp. 165-173). NY: The Haworth Press, Inc.
Sheikh JI, Yesavage JA, Brooks JO, III, Friedman LF, Gratzinger P, Hill RD, Zadeik A, Crook T (1991)
Proposed factor structure of the Geriatric Depression Scale. International Psychogeriatrics 3: 23-28.
Weeks SK, McGann PE, Michaels TK, & Penninx, BW. Comparing various short-form geriatric depression
scales leads to the GDS-5/15. Journal of Nursing Scholarship 2003;2:133-7.

Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey MB, Leirer VO. (1983) Development and
validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research
17: 37-49.