Geriatric Anxiety Scale – GAS Version 1.0

Abstract

The Geriatric Anxiety Scale (GAS) Version 1.0 is a specialized, self-report assessment instrument meticulously designed to measure symptoms of anxiety specifically within the older adult population. Recognizing the limitations and age-related biases inherent in standard anxiety measures when applied to the geriatric population, the GAS was developed to focus on the unique ways anxiety manifests across affective, somatic, and cognitive domains relevant to aging individuals. The complete scale consists of 30 items, with a subset of 25 items contributing to the total clinical score. This structure provides a comprehensive and psychometrically robust tool suitable for use in diverse samples of older adults, including community-dwelling, clinical, and medical settings.

The scale’s focus on age-specific concerns, such as health worries and fear of becoming a burden, enhances its ecological validity, making it an indispensable instrument for researchers and clinicians working in gerontology.

Keywords

Geriatric Anxiety Scale, GAS, anxiety, older adults, gerontology, psychometrics, self-report, assessment tool, somatic symptoms, cognitive worry, clinical psychology, screening tool, mood disorders.

Authors

Segal, D. L., June, A., Payne, M., Coolidge, F. L., Yochim, B.

Purpose

The primary purpose of the Geriatric Anxiety Scale (GAS) is to furnish clinicians and researchers with an accurate and reliable methodology for assessing the frequency and severity of anxiety symptoms in individuals typically aged 60 years and older. Traditional anxiety measures often fail to capture or correctly interpret the unique presentation of distress in older adults, who frequently express anxiety through physical or somatic complaints rather than overt emotional statements.

The scale aims to effectively differentiate clinically significant anxiety from general life stress and typical age-related worries, thereby facilitating the early identification, accurate diagnosis, and targeted intervention for anxiety disorders in the geriatric population. Furthermore, the establishment of a validated, age-specific tool like the GAS provides a critical foundation for advancing research into the prevalence, phenomenology, and treatment efficacy of anxiety within this demographic group.

Construct

The GAS measures the multidimensional construct of anxiety as it is experienced specifically by older adults. The scale is empirically and theoretically structured around three core factors that capture the diverse experiential components of anxiety in this age group:

• Somatic Symptoms: Items relating to the physical manifestations of anxiety, such as muscle tension, sleep disturbance, racing heart, and gastrointestinal distress.
• Cognitive Symptoms: Items covering mental aspects, including excessive worry, feelings of losing control, difficulty concentrating, and experiences of unreality or detachment.
• Affective Symptoms: Items addressing emotional distress, encompassing irritability, restlessness, anger outbursts, and specific fears like social judgment or humiliation.

The inclusion of supplemental items (26 through 30) related to common geriatric concerns—such as concerns about health, finances, or becoming a burden—ensures that the scale possesses superior ecological validity compared to standard adult anxiety measures when administered to this specific age group.

Validity

Initial validation studies, notably the foundational work by Segal et al. (2010) and the comprehensive dissertation research by Mueller (2014), provided robust evidence for the validity of the GAS. Construct validity was strongly supported by the scale’s derived three-factor structure, which aligns precisely with established theoretical dimensions of anxiety.

The GAS demonstrated strong convergent validity, showing significant positive correlations with other established measures of general anxiety and depression. Simultaneously, it maintained sufficient discriminant validity by remaining distinct from measures assessing non-anxiety related forms of distress. Crucially, the scale’s effectiveness has been proven across diverse samples—including community-dwelling, psychiatric clinical, and medical samples of older adults—indicating its robust generalizability and clinical utility.

Reliability

The Geriatric Anxiety Scale demonstrates excellent internal consistency, which is a primary indicator of reliability. Across numerous validation studies, the full 25-item version and its specialized subscales have consistently yielded high Cronbach’s alpha coefficients. This statistical consistency suggests that all items within the scale are measuring the same underlying psychological construct uniformly and accurately.

The robust psychometric properties of the GAS ensure that scores are stable over time (evidenced by strong test-retest reliability) and consistent across various measurement settings. This high degree of dependability makes the GAS a reliable instrument for tracking clinical improvement, monitoring treatment response, or conducting rigorous longitudinal research focused on anxiety in the geriatric population.

Factor Analysis

The development of the GAS employed Factor analysis to empirically determine the underlying structure of anxiety symptoms as experienced by older adults. The analysis of the initial 30-item pool led to the final 25-item clinical scale, characterized by a clear, multi-factor structure generally grouped into three distinct, yet correlated, subscales:

• Somatic Subscale (9 items): Including items 1, 2, 3, 8, 9, 17, 21, 22, and 23. These reflect physical symptoms of distress.
• Cognitive Subscale (8 items): Including items 4, 5, 12, 16, 18, 19, 24, and 25. These focus on worry and mental processes.
• Affective Subscale (8 items): Including items 6, 7, 10, 11, 13, 14, 15, and 20. These capture emotional and behavioral responses.

This established three-factor model is valuable as it provides a detailed profile of anxiety symptoms, allowing clinicians to precisely identify the specific domain (physical, mental, or emotional) where the patient is experiencing the most significant distress. It should be noted that supplementary items (26 through 30) addressing common geriatric worries are often used descriptively but are not included in the calculation of the overall 25-item clinical score.

Instrument

Test Type: Self-report questionnaire/Rating scale

Format: Paper-and-pencil or structured interview format, utilizing a 4-point Likert scale.

Language Available: Primarily English (other translations may be available in specific research contexts).

Population Group: Clinical and community-dwelling older adults.

Age Group: Geriatric population (typically individuals aged 60 years and older).

Population Details: Validated across diverse samples, including community-dwelling individuals, specialized clinical (psychiatric) populations, and medical samples of older adults.

Test Methodology: The complete scale consists of 30 items, with 25 items contributing to the clinical score. Responses are rated on a frequency scale ranging from 0 to 3, reflecting how often the symptom occurred:

• 0 = Not at all
• 1 = Sometimes
• 2 = Most of the time
• 3 = All of the time

The Total Score is calculated by summing the scores of items 1 through 25, yielding a potential range of 0 to 75. Higher scores are indicative of greater frequency and severity of anxiety symptoms. A 10-item short version, the GAS-10, is also available for rapid screening purposes.

Keywords

Geriatric assessment, psychometric instrument, mood disorders, somatic anxiety, clinical psychology, older adults, screening tool, Psychometric properties, convergent validity, discriminant validity.

Authors

Author ORCID Identifier: Not provided in source material.

Affiliation Email addresses: Not provided in source material.

Correspondence Address: Not provided in source material.

Permissions & Fee and Test Year

The Geriatric Anxiety Scale was first published and validated in 2010 by Segal, D. L., et al., appearing in the Journal of Anxiety Disorders. Permissions for clinical or research use are typically governed by the original authors and the publishing entity. Prospective users, particularly researchers, are advised to consult the primary reference source for current usage guidelines, licensing requirements, and potential associated fees.

Reference’s

• Segal, D. L., June, A., Payne, M., Coolidge, F. L., & Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: The Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24, 709-714. DOI: 10.1016/j.janxdis.2010.05.002
• Mueller, Anne Elizabeth. (2014). Psychometric properties of the geriatric anxiety scale in community-dwelling‚ clinical‚ and medical samples of older adults. A dissertation submitted to the Graduate Faculty of the University of Colorado Colorado Springs in partial fulfillment of the requirements for the degree of Doctor of Philosophy. Department of Psychology University of Colorado Colorado Springs. Kraemer Family Library.

The full instrument and detailed psychometric properties, including extensive validation data, can be found in the 2014 dissertation by Mueller. The original PDF can be downloaded here: http://digitool.library.colostate.edu///exlibris/dtl/d3_1/apache_media/L2V4bGlicmlzL2R0bC9kM18xL2FwYWNoZV9tZWRpYS8yMDg4NDI=.pdf

Items of the Geriatric Anxiety Scale – GAS Version 1.0

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. My heart raced or beat strongly.

2. My breath was short.

3. I had an upset stomach.

4. I felt like things were not real or like I was outside of myself.

5. I felt like I was losing control.

6. I was afraid of being judged by others.

7. I was afraid of being humiliated or embarrassed.

8. I had difficulty falling asleep.

9. I had difficulty staying asleep.

10. I was irritable.

11. I had outbursts of anger.

12. I had difficulty concentrating.

13. I was easily startled or upset.

14. I was less interested in doing something I typically enjoy.

15. I felt detached or isolated from others.

16. I felt like I was in a daze.

17. I had a hard time sitting still.

18. I worried too much.

19. I could not control my worry.

20. I felt restless‚ keyed up‚ or on edge.

21. I felt tired.

22. My muscles were tense.

23. I had back pain‚ neck pain‚ or muscle cramps.

24. I felt like I had no control over my life.

25. I felt like something terrible was going to happen to me.

26. I was concerned about my finances.

27. I was concerned about my health.

28. I was concerned about my children.

29. I was afraid of dying.

30. I was afraid of becoming a burden to my family or children.

GERIATRIC ANXIETY SCALE-10 ITEM VERSON (GAS-10) Items:

• I was irritable.
• I felt detached or isolated from others.
• I felt like I was in a daze.
• I had a hard time sitting still.
• I could not control my worry.
• I felt restless‚ keyed up‚ or on edge.
• I felt tired.
• My muscles were tense.
• I felt like I had no control over my life.
• I felt like something terrible was going to happen to me.