Short anxiety screening test—a brief instrument for detecting anxiety in the elderly

INTRODUCTION: The Short Anxiety Screening Test (SAST), an easily administered rating scale, was developed to standardize the detection of anxiety disorder in the elderly, even, and especially, in the presence of depression. The instrument also included somatic complaints, often the manifestation of anxiety in the elderly. Failure to relate to the anxiety component in depression may result in the initial failure of antidepressant therapy. OBJECTIVE: To validate the SAST in the elderly, especially in the presence of depression. DESIGN: The SAST was validated against a psychiatric evaluation in consecutive patients attending a geriatric service, both inpatient and outpatient. The initial validity of the SAST was tested in all the sample and subsequently in the subgroups of depressed and non-depressed. SETTING: An urban geriatric service in Israel. PATIENTS: One hundred and fifty medical inpatients and outpatients, 95 females, aged 70 years and older. MEASURES: Psychiatric evaluation of modified Anxiety Disorders Interview Schedule for DSM-IV as criterion standard for anxiety and depression, SAST for anxiety and short Zung Interview-Assisted Depression Rating Scale for depression. RESULTS: By the psychiatrist's evaluation, 40.7% suffered from anxiety. Mean SAST scores in the presence and absence of anxiety were significantly different (25.3 and 20.1; p<0.0005). The overall validity of the SAST was high (sensitivity 75.4%, specificity 78.7%). In the presence of depression, sensitivity was 83.3% and specificity 70.5%. CONCLUSION: The SAST was valid in detecting anxiety in the elderly, as well as in depressed patients. The study proved the usefulness of the SAST in a geriatric assessment programme.