Development and validation of a short form of the Geriatric Anxiety Inventory - the GAI-SF

Background: Anxiety symptoms and anxiety disorders are highly prevalent among older people and are associated with considerable disability burden. While several instruments now exist to measure anxiety in older people, there is a need for a very brief self-report scale to measure anxiety symptoms in epidemiological surveys, in primary care and in acute geriatric medical settings. Accordingly, we undertook the development of such a scale, based on the Geriatric Anxiety Inventory. Methods: This is a cross-sectional study of randomly selected, community-residing, older women (N=284; mean age 72.2 years) using receiver operating characteristic (ROC) analyses. DSM-IV diagnostic interviews were undertaken using the Mini International Diagnostic Interview, fifth edition (MINI-V). Results: We developed a 5-item version of the Geriatric Anxiety Inventory, which we have termed the Geriatric Anxiety Inventory - Short Form (GAI-SF). We found that a score of three or greater was optimal for the detection of DSM-IV Generalized Anxiety Disorder (GAD) in this community sample. At this cut-point, sensitivity was 75%, specificity was 87%, and 86% of participants were correctly classified. GAI-SF score was not related to age, MMSE score, level of education or perceived income adequacy. Internal consistency was high (Cronbach's alpha = 0.81) and concurrent validity against the State-Trait Anxiety Inventory was good (r(s) = 0.48, p<0.001). Conclusions: The GAI-SF is a short form of the Geriatric Anxiety Inventory, which we recommend for use in epidemiological studies. It may also be useful in primary care and acute geriatric medical settings.