What Is The Geriatric Depression Scale And Why Is It Important?
By: Julia Thomas
Updated May 26, 2020
Medically Reviewed By: Aaron Dutil
Often, when people think of depression, they think of people from teenagers to middle-aged adults. However, depression among the elderly is fairly common. Psychologists recognized the need to help older people who might be suffering from depression, so they developed the Geriatric Depression Scale to help identify aging adults who are experiencing symptoms of depression.
What Is the Geriatric Depression Scale?
Developed in 1982 by J.A. Yesavage and colleagues, the Geriatric Depression Scale is an assessment tool used to help identify depression in the elderly. It's typically used as part of a comprehensive geriatric assessment at a doctor's office, a nursing home, a hospital, or in other appropriate situations.
Who Is It For?
First of all, the scale is always used for elderly people. Because it is a simple test to take, it can even be used for older people who have cognitive impairments or are seriously ill. While a more complex test might be impossible for them, this assessment rarely presents a problem.
How It Works
The person giving the scale, usually a psychologist, a psychiatrist, or a physician, asks a series of questions. Each question requires only a yes or no response from the elderly person. When they have answered all the questions, the test is scored.
Long Form and Short Form Scales
There are two forms of the Geriatric Depression Scale. One is the long form, which includes 30 questions. The other is the short form, with 15 questions taken from the long form scale. The short form, of course, takes less time. Therefore, it's often more appropriate for people who have trouble sitting still, staying focused, or interacting with others.
The long form covers more of the symptoms of depression, although the questions most closely related to depression are also on the short form. Sometimes, the short form is used for screening and the long form for a more thorough assessment. However, the short form is used most often, because it's simple and takes less than 7 minutes to complete. Yet, it's still very reliable.
Scoring the Scale
For both the short form and long form tests, the scoring sheet lists the answers that are present in depressed individuals. The more of these answers that are chosen, the more severe the depression might be. For the 30-question long form, the number of answers the person chooses from the list reveals their level of depression like this:
- 0-9 matches - normal
- 10-19 matches - mild depression
- 20-30 matches - severe depression
The interpretation of the number of matches for the short form is a bit different. Here's how it goes:
- 0-5 matches - normal
- Greater than 5 matches - possible depression
- 10 or more matches - nearly always indicates depression
Why the Geriatric Depression Scale Is Important
The Geriatric Depression Scale is a useful tool for assessing the mental health of older people. However, it's much more important than getting the simple results of a test. It targets a population with many risk factors for depression, and depression affects them differently than it does younger people. Here are some of the reasons this test is so critical for the lives of elderly people who are at risk.
Depression Is Common Among Elderly People
Depression, although not a part of normal aging, happens often to older adults, especially those with serious health problems or who are living in a nursing home. While the majority of elderly people find satisfaction in life despite the problems that come with aging, depression affects from 1 to 13.5 percent of older adults, depending on their physical health and where they live.
They Face Specific Risk Factors Relating to Aging
People who are older tend to have risks for depression than younger people are less likely to have. Most older people (about 80 percent) have at least one serious health concern, while about half have two or more. Because health concerns can cause pain, worry, and loss of functioning, they can influence mood dramatically.
Another risk factor is that as you age, you tend to suffer more losses. The people you grew up with, as well as current friends your own age, are getting older just as you are. There will likely be more deaths in your life than there were when you were younger.
The elderly people who are most at risk are those who:
- Are female
- Live alone
- Are divorced
- Are widows/widowers
- Have low education level
- Are experiencing cognitive decline
- Use alcohol or tobacco
- Are physically ill
- Are on multiple medications for physical illnesses
- Have financial problems
- Have trouble taking care of themselves
Depression Affects the Elderly in Serious Ways
Depression always affects whoever has it, but for seniors, the affects can make life even more difficult. Elderly people who are depressed may have a very hard time taking care of their basic needs and may even become dependent on others to take care of them.
They may also experience greater cognitive decline when they are depressed. If they do recover from their depression, they're more likely to have a relapse than younger people are.
Without Assessment, Treatment Won't Happen
All too often, when elderly people are experiencing symptoms of depression, those around them write off their difficulties as being just a natural reaction to what's happening in their lives. However, depression is far from natural. It is a serious mental illness that can be treated successfully in many cases. But without the Geriatric Depression Scale and other tools for assessing the older person's mental health, they won't likely get the treatment they need.
Next Steps After Evaluation
After your doctor or psychiatrist scores your scale, the next step is to get treatment if you need it. There are several kinds of treatment that can help you. Here are some of the most helpful ways to overcome depression as an older adult.
Getting therapy can be crucial to an older depressed person's mental well-being. Often, younger family members don't understand that their older relatives have issues they need to discuss or personal problems they need to work out. They might not really know how to listen to an older adult and interact with them on a person-to-person level rather than simply as an old person. A therapist can provide them comfort, nonjudgmental listening, and help them learn coping skills for dealing with the problems they're facing.
Older people who recognize their need for mental health assistance can connect with a counselor at BetterHelp for online therapy. And younger people who are having trouble dealing with and helping their older family members can also get help to understand them better and manage caretaking tasks more effectively.
Therapy can help elderly people deal with:
- Physical illnesses and injuries
- Cognitive problems
- Separation from loved ones
The main goals of psychotherapy for older adults is to provide support for their:
- Ego, or self-esteem
- Ability to be hopeful
- Relationships with the supportive people in their lives
- Ability to handle problems rationally
- Ability to adapt to changes in their life
Types of psychotherapy most often used for elderly people with depression include:
- Psychodynamic therapy
- Supportive psychotherapy
- Cognitive behavioral therapy
- Group therapy
- Family therapy
- Life review therapies
Other Types of Therapy
Aside from the many forms of talk therapy, there are also other kinds of therapy that can help older people. For example, occupational therapy might be needed to help them manage their daily functioning and activities more easily. Expressive therapies can help them show and discuss their feelings through art, dance, or music. Many elderly people find handicrafts like knitting, crocheting, or leatherworking therapeutic as well.
Getting social support is critical to elderly people. Those who live alone need a chance to be with other people regularly. Often, support groups for older adults are available in the community. Many older adults find companionship and support at their church, community center, or through volunteer work if they are able.
Medications can help with depression in the elderly just as they can in people who are younger. However, antidepressants may be less effective in older adults. Often, the first antidepressant medication doesn't work and another one has to be added or substituted. For people with physical illnesses, serious injuries, and disabilities, medications may help less than for those who don't have those problems. And, in nearly all cases of elderly depression, a combined approach with both psychotherapy and medications often works best to relieve the condition.
For people who are elderly, depression can make a huge impact in their later years. If you don't know if you or a loved one is depressed, you can find out easily with the Geriatric Depression Scale. Once you answer the 15 or 30 questions with a yes or no answer, your score will reveal whether you need to explore getting treatment for depression. If your elderly family member seems to be depressed, this scale can also serve as a starting point for helping them live a better, more satisfying life.
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