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Geriatric Anxiety Scale

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G
Geriatric Anxiety Scale
Daniel L. Segal, Katie L. Granier,
Marissa A. Pifer and Lisa E. Stone
Department of Psychology,
University of Colorado at Colorado Springs,
Colorado Springs, CO, USA
Definition
The Geriatric Anxiety Scale (GAS; Segal et al.
2010) is a 30-item self-report measure designed to
assess, screen, and quantify severity of anxiety
symptoms among older adults. The GAS is an
increasingly popular and widely used screening
measure for anxiety which has a wealth of psy-
chometric data supporting its use in diverse com-
munity, medical, and clinical samples.
Overview
Development
Development of the GAS was spurred by the
urgent need for brief, self-report screening
measures of anxiety designed and validated spe-
cifically for use with older adult populations. A
specific aspiration was to develop a measure that
covers three common domains of anxiety symp-
toms among older adults (i.e., somatic, cognitive,
and affective symptoms). Indeed, these three
domains are hallmarks of anxiety that are
© Springer Nature Switzerland AG 2019
D. Gu, M. E. Dupre (eds.), Encyclopedia of Gerontology and Population Aging,
https://doi.org/10.1007/978-3-319-69892-2_1103-1
commonly assessed during a thorough clinical
evaluation of anxiety (Segal et al. 2018). Initially,
items were derived from the full range of anxiety
disorder symptoms in the DSM-IV-TR, most of
which remained unchanged in DSM-5. Then, pre-
liminary analyses identified items that were most
heavily endorsed by older adults, items that were
endorsed more by older adults than younger
adults, and items that improved internal consis-
tency of the measure. The final 30-item measure
includes 25 scorable items and 5 content items
(described below).
Scoring
During administration, respondents are asked to
rate symptoms of anxiety by indicating how often
they have experienced each symptom during the
last week, answering on a 4-point Likert-type
scale ranging from 0 (not at all) to 3 (all of the
time). Scoring provides a total score and three
subscale scores (somatic symptoms, cognitive
symptoms, and affective symptoms) for which
normative and interpretive guidelines are avail-
able. The GAS total score is based on the first 25
items. Possible total scores range from 0 to 75,
with higher scores indicating the presence of more
severe anxiety. The somatic subscale contains
nine items, the cognitive subscale contains eight
items, and the affective subscale contains eight
items. Each scorable item loads on only one sub-
scale. The additional 5 items on the GAS (items
26–30) are not scorable but rather assess areas of
anxiety commonly reported to be of concern for
2 Geriatric Anxiety Scale
older adults: concern about finances, concern
about one’s health, concern about children, fear
of dying, and fear of becoming a burden to others.
These content items are used clinically and thus
do not load on any score.
Key Research Findings
Internal Consistency
As depicted in Table 1, the GAS demonstrates
excellent internal consistency of scale scores
across six samples of community-dwelling older
adults (a = 0.90–0.95). The GAS also demon-
strated excellent internal consistency among older
adults with one or more chronic medical condition
(a = 0.94), and older adults meeting criteria for
one or more anxiety disorder or seeking outpatient
mental health treatment (a = 0.91–0.93), making
it a well-rounded measure for use in different
settings. Across the aforementioned samples, the
total GAS averaged an excellent Cronbach’s a of
0.92. The cognitive (mean a = 0.85), somatic
(mean a = 0.77), and affective (mean a = 0.83)
subscales demonstrated good or acceptable aver-
age internal consistency across the samples. As
depicted in Table 2, the cognitive (mean r = 0.92),
somatic (mean r = 0.89), and affective (mean
r = 0.92) subscales were also strongly correlated
with the total GAS in two community and two
clinical samples. Item response theory analyses
performed by Mueller et al. (2015) on the entire
GAS showed that each item reliably contributes to
the assessment of anxiety, further supporting these
findings.
Construct Validity
Older Adults. The GAS has demonstrated robust
convergent validity through its strong correlations
with other well-validated measures of anxiety
and worry, including the State-Trait Anxiety
Inventory, Beck Anxiety Inventory (BAI), Adult
Manifest Anxiety Scale-Geriatric Version,
Geriatric Anxiety Inventory (GAI), Hamilton
Anxiety Scale, Anxiety Sensitivity Index-3, and
Penn State Worry Questionnaire with medium to
large effect sizes (see Table 3). Yochim et al.
(2011) found that the GAS was most highly
correlated with the Geriatric Depression Scale
(GDS) as opposed to the BAI or GAI. However,
the GAS also correlated more strongly with both
the BAI and GAI than the two measures correlated
with each other, indicating that the GAS may
more comprehensively assess the symptoms of
anxiety covered by both of these measures.
The GAS was closely related to measures
of depression including the Beck Depression
Inventory-II, GDS, and Patient Health Question-
naire-9 as well as a measure of
distress management (Acceptance and Action
Questionnaire-II), with large effect sizes. The
lack of discriminant validity with measures of
depression has been critiqued as a weakness of
the GAS. However, due to depression and anxiety
being highly related constructs, especially in later
life, as well as the high rates of comorbidity and
use of the DSM criteria within the GAS, this
relationship is to be expected. The GAS subscales
also differ in the strength of their relations to
measures of depression, with the somatic subscale
demonstrating lower correlation coefficients than
the cognitive and affective subscales (see Table
3), indicating that specific domains may have
greater discriminant value and can be used to
better assess differential diagnoses.
The GAS also demonstrated good convergent
validity with measures of health and medical
burden including the 36-item Short Form Survey,
Comorbidity Index, and general health ratings as
expected with medium to large effect sizes. The
somatic subscale of the GAS had higher correla-
tion coefficients with these measures compared
to the cognitive and affective scales, indicating
good construct validity for the domains they
were specifically designed to assess. The GAS
also demonstrated strong convergent validity
with measures of PTSD (i.e., Posttraumatic Stress
Disorder Checklist-Civilian version), mindfulness
(i.e., Mindful Attention Awareness Scale,
Kentucky Inventory of Mindfulness Skills), and
overall functioning (i.e., Global Assessment of
Functioning). The GAS showed good discrimi-
nant validity with demographic variables (i.e.,
education, sex, age). The GAS and its subscales
also had small to no association with cognitive
measures such as the California Verbal
Geriatric Anxiety Scale 3

Geriatric Anxiety Scale, Table 1 Summary of internal consistency of the GAS in older adults across multiple studies
Study Total GAS Cognitive Somatic Affective
Segal et al. (2010) 0.93 0.90 0.80 0.82
Segal et al. (2010)a 0.93 0.85 0.80 0.82
Yochim et al. (2011) 0.90 – – –
Yochim et al. (2013) 0.91 0.74 0.74 0.83
Gould et al. (2014) 0.90 0.84 0.68 0.80
Mahoney et al. (2015) 0.95 0.90 0.87 0.89
Gould et al. (2018) 0.90 0.84 0.68 0.80
Gould et al. (2019)b 0.91 – – –
Segal and Mueller (2019)c 0.94 0.89 0.79 0.87
Mean alphas 0.92 0.85 0.77 0.83
Note: Dashes indicate unreported data. All data is reported as Cronbach’s a. Gould et al. (2019) did not report individual
alphas for each subscale. However, the subscales were reported to have acceptable to good reliability (0.75–0.88)
a
Clinical sample of outpatients seeking psychological treatment
b
Community sample who met criteria for one or more anxiety disorder
c
Clinical sample of older adults with at least one chronic health condition

Geriatric Anxiety Scale, Table 2 Subscale-total correlations in older adult samples across three studies
Scale Yochim et al. (2013) Segal and Mueller (2019) Segal et al. (2010) Segal et al. (2010) Mean r
Cognitive 0.90 0.94 0.91 0.91 0.92
Somatic 0.91 0.87 0.86 0.91 0.89
Affective 0.92 0.93 0.92 0.91 0.92
Note: Italic text indicates data from a clinical sample
p < 0.01

Learning Test-II, trail making 20 Question Initial
Abstraction, letter fluency, category fluency,
Wechsler Adult Intelligence Scale-III Digit-Sym-
bol Coding, Rey Auditory Verbal Learning Test,
and visual reproduction, thus demonstrating good
discriminant validity (Gould et al. 2014; Yochim
et al. 2011, 2013).
Impact of Memory. Gould et al. (2014)
observed minor shifts in the psychometric prop-
erties of the GAS in samples of different cognitive
functioning. There was reduced but still good
internal consistency on the GAS scale scores for
average compared to superior performers on
verbal and visual memory tasks. The convergent
validity of the GAS was stable when assessing
the impact of varying memory abilities on the
measure. Some discrepancies in discriminant
validity were found between average and superior
memory groups. These findings suggest that
slight changes in the GAS’ reliability and validity
may be observed as a result of respondents’ cog-
nitive abilities.
Other Properties
Mueller et al. (2015) found that the GAS is most
reliable in distinguishing individuals at the higher
end of the anxiety spectrum, as opposed to
the very low end. However, these researchers
emphasize that this is not problematic because
clinicians are typically interested in elevated
levels of anxiety. Additionally, their results
suggested that each item on the GAS is a reliable
indicator of anxiety. Somatic items provided
the least amount of information compared to
cognitive and affective, likely because of the
physical ailments commonly endorsed by older
adults. However, they were still informative, and
their inclusion distinguishes the GAS from
other measures of anxiety. Indeed, evidence sug-
gests that the subscales have clinical and practical
4 Geriatric Anxiety Scale

Geriatric Anxiety Scale, Table 3 Summary of convergent and discriminant validity across seven studies in older adults
Measure Total GAS Cognitive Somatic Affective
STAI-trait total 0.79 0.81 0.57 0.75
STAI-state total 0.74 0.78 0.50 0.71
STAI-Y1 0.77 – – –
BAI 0.60 0.82 0.53 0.79 0.61 0.70 0.45 0.76
AMAS 0.77 0.74 0.65 0.69
Worry 0.76 0.75 0.62 0.67
Physiological 0.65 0.65 0.54 0.55
Fear of aging 0.46 0.40 0.44 0.39
GAI 0.60 0.82 0.74 0.85 0.43 0.61 0.65 0.80
HAM-A 0.60 – – –
ASI-3 0.37 – – –
PSWQ 0.57 – – –
BDI-II 0.59 0.73 0.81 0.65 0.65
GDS 0.73 0.78 0.67 0.82 0.53 0.68 0.72 0.76
PHQ-9 0.84 0.80 0.67 0.83
SF-36 0.68 0.60 0.66 0.62
CMI 0.34 0.28 0.38 0.22
GAF 0.39 0.38 0.34 0.37
Health rating 0.29 – – –
PCL-C 0.60 – – –
WTAR 0.36 – – –
AAQ-II 0.70 – – –
MAAS 0.69 – – –
KIMS 0.54 – – –
Education 0.01 0.20 0.10 0.01 0.06
Sex 0.06 0.15 – – –
Age 0.08 0.18 – – –
Bolded text indicates use of Spearman correlations to account for positive skewness
Italic text indicates data from a clinical sample
STAI, State-Trait Anxiety Inventory; STAI-Y1, State-Trait Anxiety Inventory Form Y1; BAI, Beck Anxiety Inventory;
AMAS, Adult Manifest Anxiety Scale-Geriatric Version; GAI, Geriatric Anxiety Inventory; HAM-A, Hamilton
Anxiety Scale; ASI-3, Anxiety Sensitivity Index-3; PSWQ, Penn State Worry Questionnaire; BDI-II, Beck Depression
Inventory-II; GDS, Geriatric Depression Scale; PHQ-9, Patient Health Questionnaire-9; SF-36, 36-item Short Form
Survey; CMI, Comorbidity Index; GAF, Global Assessment of Functioning; PCL-C, Posttraumatic Stress Disorder
Checklist-Civilian version; WTAR, Wechsler Test of Adult Reading. AAQ-II, Acceptance and Action Questionnaire-II;
MAAS, Mindful Attention Awareness Scale; KIMS, Kentucky Inventory of Mindfulness Skills
p < 0.05; p < 0.01

utility; however, they should be used with appro-
priate caution.
Mueller et al. (2015) also used item response
theory to explore potential age (under 80 vs. over
80 years) and sex (male vs. female) bias on the
GAS. They found that two items were biased, one
for age and one for sex. However, they argue that
the amount of bias was extremely minimal, and
they recommend retaining the items on the mea-
sure. The minimal age and sex bias on the GAS
indicate that it is useful among all older adults
rather than just the young-old or women. The
GAS is best used to distinguish individuals at the
high end of the anxiety spectrum, which is logical
given its development as a clinical instrument.
Based on an efficiency of 89%, Gould et al.
(2014) identified a cutoff score of >16 with a
sensitivity of 0.40 and specificity of 0.94 as opti-
mal at the p < 0.01 level, indicating that the >16
cutoff score correctly classified participants 89%
Geriatric Anxiety Scale
of the time in this study. However, a less stringent
cutoff score of >9 was also identified with an
efficiency of 73% and more balanced sensitivity
(0.60) and specificity (0.75). These findings
suggest that a narrower cutoff score of >16 is
recommended to attain the highest percentage of
correct classification. However, a broader cutoff
score of >9 is recommended for a more balanced
chance of correctly identifying both those with
and without clinical levels of anxiety.
Examples of Application
Alternate Forms
There are two alternative versions available for
use by researchers and clinicians when the full
GAS may not be appropriate. These include the
Geriatric Anxiety Scale-10 (GAS-10), a 10-item
short form, and the Geriatric Anxiety Scale-Long
Term Care (GAS-LTC), a 10-item version created
for use within long-term care settings. The GAS-
10 was created from the full GAS, as short forms
are often preferred in busy clinical and research
settings where time is limited. The GAS-10 was
created using item response theory, which identi-
fied items on the GAS that provided the most
information about a person’s anxiety and that
were best able to discriminate endorsement of
the item based on actual anxiety, rather than a
certain personality or character trait (Mueller et
al. 2015). Items from the full GAS with the
highest discrimination parameters and informa-
tion curve peaks were selected from each subscale
in order to ensure that the GAS-10, although
shorter, still captured cognitive, affective, and
somatic components of anxiety. Three items
were selected from the somatic subscale, three
were selected from the affective subscale, and
four were selected from the cognitive subscale.
Mueller et al. (2015) suggested that the GAS-10
best assesses anxiety for people with average
anxiety, up to 2.5 standard deviations above the
mean and that the reduced items of GAS-10
did not significantly reduce precision of anxiety
detection. The GAS-10 had excellent internal
consistency (a = 0.89) and was significantly, pos-
itively correlated with the full GAS (r = 0.96,
5
p < 0.001). Results of this study provide strong
support for the use of the GAS-10, especially
when time is limited or when individuals being
assessed may fatigue easily and not be able to
tolerate longer measures. Despite having fewer
items, the GAS-10 still provides good amounts
of symptom information and is still precise in
detecting anxiety for older adults.
The GAS-LTC was created to address the gap
in assessment measures available and validated
for use in long-term care settings. The GAS-LTC
was created by modifying the GAS-10 with sim-
pler language and replacing the Likert-type
response format with a more simple yes-no
response format. Preliminary psychometric vali-
dation for the GAS-LTC by Pifer et al. (2019) was
conducted with 66 older adult long-term care res-
idents. Results revealed good internal consistency
for the GAS-LTC (a = 0.80). Item-total correla-
tions ranged from moderate to strong positive
correlations (range r: 0.35–0.65) between each
item and the total GAS-LTC score, indicating
that all items on the GAS-10 meaningfully con-
tribute to the total score. Tests of convergent
validity for the GAS-LTC revealed a strong posi-
tive correlation between the GAS-LTC and the
GAI (r = 0.70, p < 0.01), indicating that both
are measuring similar constructs but are not iden-
tical (Pifer et al. 2019). The GAS-LTC was also
strongly positively correlated with a measure of
depression, the Geriatric Depression Scale-15
(GDS-15; r = 0.67, p < 0.01). As noted above,
depression has regularly been shown to be related
to anxiety, with both disorders having significant
symptom overlap and strong correlations between
depression and anxiety measures (Cairney et al.
2008). Therefore, it is expected that the GAS-LTC
would relate strongly to a measure of depression.
Results from this study showed strong support
for the use of the GAS-LTC in long-term care
settings. However, this was the first study to date
to use the GAS-LTC, and further studies examin-
ing the psychometric properties of the GAS-LTC
are needed, with larger and more diverse samples.
Translated and International Versions
At present, the GAS has been formally translated
into six languages: Persian (Bolghan-Abadi et al.
6 Geriatric Anxiety Scale

2013), German (Gottschling et al. 2016), Chinese the GAS appears to be an excellent measure of
(Xiao-Ling et al. 2017), Arabic (Hallit et al. late-life anxiety and should be considered for use
2017), Turkish (Karahan et al. 2018), and Italian in research studies aiming to examine a wide
(Gatti et al. 2018). Each of these versions variety of anxiety symptoms among older adults.
underwent a rigorous translation process to ensure
that the translated measure was culturally and
semantically appropriate. Then, the psychometric
Future Directions of Research
properties of each translated measure were care-
fully evaluated, with these measures generally
New avenues for research on the GAS may
demonstrating strong evidence of reliability and
examine alternative methods of administration
validity, typically comparable to the original
for those unable to complete the self-report
English version. Other informal translations of
measure independently, for example, through
the GAS are also available in several additional
computer-assisted administration, oral adminis-
languages (e.g., Spanish, Korean, Vietnamese,
tration, or by gathering data from collateral
Japanese, and Croatian), but these measures
reports. In addition, further studies should explore
have not yet been formally evaluated.
the psychometric properties of the GAS among
the oldest-old populations (those 85 years old and
Research Applications older), since this is the fastest growing segment of
The GAS has been used as a measure of anxiety older people. Finally, research is needed to
in numerous empirical studies with older adults. explore the psychometric properties and clinical
For example, Gould et al. (2019) used the GAS utility of the GAS in culturally and ethnically
as a treatment outcome measure to assess effec- diverse older adult populations in the USA and
tiveness of a video-delivered relaxation interven- internationally, with extensive opportunities for
tion among older adults. The intervention was not the further development of culturally and linguis-
designed to target one specific anxiety diagnosis, tically appropriate translated versions of the
so the GAS was selected as the outcome measure measure.
because of its ability to assess a diverse array
of anxiety symptoms. Results demonstrated that
the GAS was sensitive to clinical change as an
Summary
outcome measure. Specifically, the GAS was able
to detect treatment changes in individuals with
The GAS is an increasingly popular self-report
generalized anxiety disorder, social anxiety
measure of anxiety that has been successfully
disorder, panic disorder, agoraphobia, and anxiety
used in diverse community, psychiatric, and med-
disorder unspecified. The GAS has also been
ical samples of older adults. The available psy-
utilized to examine relationships between late-
chometric data strongly supports its use in diverse
life anxiety and other domains, including cogni-
clinical and research endeavors.
tive impairment (Yochim et al. 2013), sleeping
difficulties (Gould et al. 2018), and loneliness
(Khademi et al. 2015). Mahoney et al. (2015)
examined age differences in experiential avoid- Cross-References
ance, anxiety sensitivity, and mindfulness, using
the GAS as a measure of state anxiety symptoms. ▶ Anxiety About Aging
This study illustrates that the GAS can be used in ▶ Geriatric Anxiety Inventory
cross-sectional age studies in order to adequately ▶ Geriatric Mental Health
capture state anxiety among both younger and ▶ Psychopathology
older samples. Overall, these studies suggest that
Geriatric Anxiety Scale
References
Bolghan-Abadi M, Segal DL, Coolidge FL et al (2013)
Persian version of the Geriatric Anxiety Scale: transla-
tion and preliminary psychometric properties among
Iranian older adults. Aging Mental Health
17:896–900. https://doi.org/10.1080/13607863.2013.
788999
Cairney J, Corna LM, Veldhuizen S et al (2008) Comorbid
depression and anxiety in later life: patterns of
association, subjective well-being, and impairment.
Am J Geriatr Psychiatry 16:201–208. https://doi.org/
10.1097/JGP.0b013e3181602a4a
Gatti A, Gottschling J, Brugnera A et al (2018) An
investigation of the psychometric properties of the
Geriatric Anxiety Scale (GAS) in an Italian sample
of community-dwelling older adults. Aging Mental
Health 22:1170–1178. https://doi.org/10.1080/136078
63.2017.1347141
Gottschling J, Segal DL, Häusele C et al (2016) Assess-
ment of anxiety in older adults: translation and psycho-
metric evaluation of the German version of the
Geriatric Anxiety Scale (GAS). J Psychopathol Behav
Assess 38:136–148. https://doi.org/10.1007/s10862-
015-9504 -z
Gould C, Segal DL, Yochim BP et al (2014) Measuring
anxiety in late life: a psychometric examination of the
Geriatric Anxiety Inventory and Geriatric Anxiety
Scale. J Anxiety Disord 28:804–811. https://doi.org/
10.1016/j.janxdis.2014.08.001
Gould CE, Spira AP, Liou-Johnson V et al (2018)
Associations of anxiety symptom clusters with sleep
quality and daytime sleepiness. J Gerontol B Psychol
Sci Soc Sci 73:413–420. https://doi.org/10.1093/geron
b/gbx020
Gould CE, Kok BC, Ma VK et al (2019) Video-delivered
relaxation intervention reduces late-life anxiety: a pilot
randomized controlled trial. Am J Geriatr Psychiatry
27:514–525. https://doi.org/10.1016/j.jagp.2018.12.
018
Hallit S, Hallit R, Hachem D et al (2017) Validation of the
Arabic version of the Geriatric Anxiety Scale among
Lebanese population of older adults. J Psychopathol
23:26–34
Karahan FS, Hamarta E, Karahan AY (2018) The Turkish
adaptation and psychometric properties of the Geriatric
View publication stats
7
Anxiety Scale. Ment Illn 10:1–5. https://doi.org/
10.4081/mi.2018.7580
Khademi MJ, Rashedi V, Sajadi S et al (2015) Anxiety and
loneliness in the Iranian older adults. Int J Psychol
Behav Sci 5:49–52
Mahoney CT, Segal DL, Coolidge FL (2015) Anxiety
sensitivity, experiential avoidance, and mindfulness
among younger and older adults: age differences in
risk factors for anxiety symptoms. Int J Aging Hum
Dev 81:217–240. https://doi.org/10.1177/009141501
5621309
Mueller AE, Segal DL, Gavett B et al (2015) Geriatric
anxiety scale: item response theory analysis, differen-
tial item functioning, and creation of a ten-item short
form (GAS-10). Int Psychogeriatr 27:1099–1111.
https://doi.org/10.1017/S1041610214000210
Pifer MA, Segal DL, Noel OR et al (2019) Development
and validation of the geriatric anxiety scale-long term
care version. Poster presented at the 127th American
Psychological Association Annual Convention,
Chicago
Segal DL, Mueller AE (2019) Evidence of validity of the
geriatric anxiety scale for use among medically ill older
adults. J Depress Anxiety Forecast 2:1010
Segal DL, June A, Payne M et al (2010) Development and
initial validation of a self-report assessment tool for
anxiety among older adults: the geriatric anxiety
scale. J Anxiety Disord 24:709–714. https://doi.org/
10.1016/j.janxdis.2010.05.002
Segal DL, Qualls SH, Smyer MA (2018) Aging and mental
health, 3rd edn. Wiley/Blackwell, Hoboken
Xiao-Ling L, Lu D, Gottschling J et al (2017) Validation of
a Chinese version of the geriatric anxiety scale among
community-dwelling older adults in mainland China. J
Cross Cult Gerontol 32:57–70. https://doi.org/10.1007/
s10823-016-9302-4
Yochim BP, Mueller AE, June A et al (2011) Psychometric
properties of the geriatric anxiety scale: comparison to
the Beck anxiety inventory and geriatric anxiety inven-
tory. Clin Gerontol 34:21–33. https://doi.org/10.1080/
07317115.2011.524600
Yochim BP, Mueller A, Segal DL (2013) Late life anxiety
is associated with decreased memory and executive
functioning in community dwelling older adults. J Anx-
iety Disord 27:567–575. https://doi.org/10.101 6/j.
janxdis.2012.10.010