ABSTRACT
The Geriatric Depression Scale (GDS) is a widely used instrument developed in the early 1980s as a measure of geriatric depressive symptomatology. It is a measure well suited for use as a screening and/or monitoring instrument in primary care settings where qualities such as brevity, sensitivity, and specificity are valued. A relatively extensive literature on the GDS is reviewed in this chapter, accompanied by suggestions for its use. Our opinion is that use of the GDS in primary care settings would improve the detection of depression among older adults. This is an important and worthwhile goal for at least a couple of reasons. First, depression has been reliably associated with increase health care use (Callahan, Hui, Nienaber, Musick, & Tierney, 1994). Second, geriatric depression is a treatable disorder (Friedhoff, 1994).
The development of the GDS was motivated by the perception that existing self-report measures of depression were lacking when used with older adults (e.g., Jarvik, 1976; Kane & Kane, 1981; Salzman & Shader, 1978). The most frequently expressed concerns were with somatic symptoms of depression, including energy, sex, sleep, and gastrointestinal difficulties, as these tended to be unreliable indicants of depression when evaluated in elders. Other concerns included the confusion often engendered by the multiple-response format of extant instruments, especially with older adults experiencing mild to moderate cognitive impairment. The lack of norms for older adults was frequently expressed as a shortcoming as well. These concerns coincided with the maturation of the field of geriatric mental health to the point that investigators were ready to develop a self-report depression instrument specifically geared for older adults.
