Key result
The 10-item Geriatric Anxiety Scale (GAS-10) demonstrated fair diagnostic accuracy in discriminating older adults with Generalized Anxiety Disorder from non-clinical adults, with an AUC of 0.702.
Why the study?
The diagnostic accuracy and discriminative power in clinical samples of the 10-item Geriatric Anxiety Scale remained unexplored.
Does the 10-item Geriatric Anxiety Scale (GAS-10) demonstrate adequate psychometric properties and diagnostic accuracy compared to the long form in elderly populations?
Cross-Sectional (n=1,464)
Does the 10-item Geriatric Anxiety Scale (GAS-10) demonstrate adequate psychometric properties and diagnostic accuracy compared to the long form in elderly populations?
Effect estimate: AUC 0.702 (95% CI 0.643-0.757)
The GAS-10 is a valid and reliable brief tool for assessing and diagnosing geriatric anxiety symptoms, performing comparably to the longer version.
GAS-10 may support brief geriatric anxiety screening; leaves open prospective validation before clinical adoption.
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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Carlucci et al. (2021) conducted a cross-sectional in Geriatric Anxiety / Generalized Anxiety Disorder (n=1,464). 10-item Geriatric Anxiety Scale (GAS-10) vs. Clinical diagnosis / GAS-long form was evaluated on Diagnostic accuracy (Area Under the Curve) for Generalized Anxiety Disorder (AUC 0.702, 95% CI 0.643-0.757). The 10-item Geriatric Anxiety Scale (GAS-10) demonstrated fair diagnostic accuracy in discriminating older adults with Generalized Anxiety Disorder from non-clinical adults, with an AUC of 0.702.
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