1
|
Britting S, Kob R, Görlitz A, Sieber CC, Freiberger E, Rohleder N. Chronic stress and functional health in older adults with concerns about falling: a study protocol of a randomized controlled trial with multicomponent exercise intervention (FEARFALL). Trials 2024; 25:621. [PMID: 39304954 PMCID: PMC11414122 DOI: 10.1186/s13063-024-08462-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Accepted: 09/06/2024] [Indexed: 09/22/2024] Open
Abstract
BACKGROUND Maintenance of physical function, mobility, and independent living are important goals for older adults. However, concerns about falling (CaF) play a central role in the vicious cycle of CaF, inflammation, loss of muscle mass, and decreasing physical function ultimately resulting in negative health outcomes. CaF, like other states of chronic stress and anxiety, can be considered as enduring adverse stimuli affecting the stress systems and the inflammatory system. Therefore, the aim of this study is to investigate whether a reduction of CaF leads to a reduction of stress and therefore possibly reduces chronic low-grade inflammation. Understanding the role and directionality of the effects of inflammation on CaF increases our understanding of age-related loss of mobility and physical function. METHODS In this study, community-dwelling older adults, aged 70 years and older, will be randomly assigned to either a 4-month, multi-component intervention with exercise training and cognitive-behavioral components or to a sham control group with light stretching exercises, cognitive training, and educational health lectures. For the operationalization of specific CaF, the Falls Efficacy Scale-International will be used. Stress and related psychological symptoms will be monitored using established self-reports and by measuring salivary cortisol. Concentrations of C-reactive protein, interleukin 6, interleukin 10, and tumor-necrosis-factor-alpha, as well as gene expression of selected inflammatory transcripts, will be used as surrogate parameters of the inflammatory status at baseline, after the 4-month intervention and 8-month follow-up. DISCUSSION This study will be the first to test whether CaF are related with stress system activity or reactivity or with markers of inflammation in the context of a multi-component intervention with exercise training and cognitive-behavioral components addressing CaF. The reduction of specific CaF or general psychological symptoms should reverse alterations in stress systems, and / or slow down low-grade inflammation. Changes in activity, as well as psychological and biological pathways leading from CaF to muscle loss will be measured, to disentangle the individual contribution to sarcopenia, and to provide an additional pathway to break or slow-down the vicious cycle of CaF and sarcopenia. TRIAL REGISTRATION German Clinical Trials Register (DRKS): DRKS00029171 . Registered 22 July 2022.
Collapse
Affiliation(s)
- Sabine Britting
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, Nuremberg, Bavaria, 90408, Germany.
| | - Robert Kob
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, Nuremberg, Bavaria, 90408, Germany
| | - Anja Görlitz
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany
| | - Cornel C Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, Nuremberg, Bavaria, 90408, Germany
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-Universität Erlangen-Nürnberg, Kobergerstraße 60, Nuremberg, Bavaria, 90408, Germany
| | - Nicolas Rohleder
- Department of Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| |
Collapse
|
2
|
Angonese G, Buhl M, Kuhlmann I, Kollmeier B, Hildebrandt A. Prediction of Hearing Help Seeking to Design a Recommendation Module of an mHealth Hearing App: Intensive Longitudinal Study of Feature Importance Assessment. JMIR Hum Factors 2024; 11:e52310. [PMID: 39133539 PMCID: PMC11347899 DOI: 10.2196/52310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 02/22/2024] [Accepted: 05/02/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Mobile health (mHealth) solutions can improve the quality, accessibility, and equity of health services, fostering early rehabilitation. For individuals with hearing loss, mHealth apps might be designed to support the decision-making processes in auditory diagnostics and provide treatment recommendations to the user (eg, hearing aid need). For some individuals, such an mHealth app might be the first contact with a hearing diagnostic service and should motivate users with hearing loss to seek professional help in a targeted manner. However, personalizing treatment recommendations is only possible by knowing the individual's profile regarding the outcome of interest. OBJECTIVE This study aims to characterize individuals who are more or less prone to seeking professional help after the repeated use of an app-based hearing test. The goal was to derive relevant hearing-related traits and personality characteristics for personalized treatment recommendations for users of mHealth hearing solutions. METHODS In total, 185 (n=106, 57.3% female) nonaided older individuals (mean age 63.8, SD 6.6 y) with subjective hearing loss participated in a mobile study. We collected cross-sectional and longitudinal data on a comprehensive set of 83 hearing-related and psychological measures among those previously found to predict hearing help seeking. Readiness to seek help was assessed as the outcome variable at study end and after 2 months. Participants were classified into help seekers and nonseekers using several supervised machine learning algorithms (random forest, naïve Bayes, and support vector machine). The most relevant features for prediction were identified using feature importance analysis. RESULTS The algorithms correctly predicted action to seek help at study end in 65.9% (122/185) to 70.3% (130/185) of cases, reaching 74.8% (98/131) classification accuracy at follow-up. Among the most important features for classification beyond hearing performance were the perceived consequences of hearing loss in daily life, attitude toward hearing aids, motivation to seek help, physical health, sensory sensitivity personality trait, neuroticism, and income. CONCLUSIONS This study contributes to the identification of individual characteristics that predict help seeking in older individuals with self-reported hearing loss. Suggestions are made for their implementation in an individual-profiling algorithm and for deriving targeted recommendations in mHealth hearing apps.
Collapse
Affiliation(s)
- Giulia Angonese
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Mareike Buhl
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- IHU reConnect, Institut de l'Audition, Fondation Pour l'Audition, Inserm, AP-HP, Institut Pasteur, Université Paris Cité, F-75012 Paris, France
| | - Inka Kuhlmann
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Birger Kollmeier
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Department of Medical Physics and Acoustics, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| | - Andrea Hildebrandt
- Cluster of Excellence Hearing4All, Oldenburg, Germany
- Psychological Methods and Statistics Lab, Department of Psychology, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
- Research Center Neurosensory Science, Carl von Ossietzky Universität Oldenburg, Oldenburg, Germany
| |
Collapse
|
3
|
Heimrich KG, Schönenberg A, Mendorf S, Moussaoui J, Prell T. An examination of anxiety and its influence on health-related quality of life in Parkinson's disease using the geriatric anxiety scale: a cross-sectional study. BMC Geriatr 2024; 24:298. [PMID: 38549058 PMCID: PMC10979635 DOI: 10.1186/s12877-024-04911-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Anxiety is one of the most common but often overlooked mood-related nonmotor symptoms in people with Parkinson's disease (PD). To improve the well-being of people with PD, it is important to understand the impact of anxiety in PD, especially its association with depressive and motor symptoms and its impact on health-related quality of life (HRQoL). METHODS 91 people with PD were assessed between June 2017 and June 2018. Anxiety was measured using the Geriatric Anxiety Scale (GAS) and its cognitive, somatic, and affective subscales. HRQoL was assessed using the Parkinson's Disease Questionnaire 39 (PDQ-39). Moreover, sociodemographic information, depressive symptoms, cognition, motor and nonmotor symptoms were assessed. Descriptive statistics, regression analyses, and path analyses were performed to understand predictors of anxiety and its influence on HRQoL. RESULTS Of the 91 people with PD, 35 (38.5%) experienced anxiety. Anxiety symptoms in these individuals primarily manifest as somatic sensations. Anxiety, motor, and depressive symptoms are interlinked but contribute individually to HRQoL. Beyond motor symptoms, cognitive and affective aspects of anxiety impact HRQoL. While anxiety and depression overlap, the somatic and cognitive aspects of anxiety play a significant role in determining HRQoL in addition to depressive symptoms. CONCLUSION Our study used the GAS and its three subscales to shed light on the connections between anxiety, depression, and motor impairment in people with PD. Although anxiety is linked to depression and motor symptoms, it independently affects the HRQoL of people with PD. Thus, it is crucial to adopt a comprehensive diagnostic approach that detects and considers the impact of anxiety on HRQoL in PD.
Collapse
Affiliation(s)
- Konstantin G Heimrich
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
| | - Aline Schönenberg
- Department of Geriatrics, Halle University Hospital, Ernst-Grube-Straße 40, 06120, Halle, Germany
| | - Sarah Mendorf
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Juliane Moussaoui
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
- Department of Trauma, Hand and Reconstructive Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany
- Department of Geriatrics, Halle University Hospital, Ernst-Grube-Straße 40, 06120, Halle, Germany
| |
Collapse
|
4
|
Maraqa BN, Nazzal Z, Hamshari S, Alutt B, Rishmawi E, Qawasmeh A. Prevalence of depression and anxiety among elderly primary care patients in Palestine. Front Psychiatry 2024; 14:1291829. [PMID: 38312914 PMCID: PMC10836403 DOI: 10.3389/fpsyt.2023.1291829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 12/19/2023] [Indexed: 02/06/2024] Open
Abstract
Background and objectives Depression and anxiety are common mental health disorders among the elderly worldwide. In this study, we estimated the prevalence of depression and anxiety and related risk factor among elderly attending Primary Health care (PHC) centers in Palestine. Methods A cross-sectional study was conducted from February to July 2021 with a sample size of 380 participants aged ≥60 attending PHC centers in West Bank, using an interviewer-administered questionnaire. We used the Geriatric Depression Scale-15 and the Geriatric anxiety Scale to screen for depression and anxiety, respectively. Logistic regression models were used to identify predictors of depression and anxiety. Results The prevalence of depression and anxiety was 41.1 and 39.2%, respectively. Elderly people living in rural areas (aOR = 2.63; 95% CI: 1.72-4.20), uneducated (aOR = 2.92; 95% CI: 1.41-6.13), and without monthly income (aOR = 3.42; 95% CI: 1.52-7.61) were more likely to have depression. On the other hand, anxiety was independently associated with living in rural areas (aOR = 1.93, 95% CI: 1.23-3.04) and having non-communicable diseases (aOR = 2.01; 95% CI: 1.13-3.49). Conclusion Depression and anxiety are common in Palestine, a developing country with a lack of elderly related services. This should be emphasized at the national and regional levels where geriatric health care services are scarce. Such information is required by policymakers and external funding agencies in order to develop future agendas.
Collapse
Affiliation(s)
| | - Zaher Nazzal
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Suha Hamshari
- Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Barlant Alutt
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ekram Rishmawi
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | | |
Collapse
|
5
|
Kashimura M, Ishizu K, Kokubo N, Segal DL. Assessing late-life anxiety in Japanese older adults: psychometric evaluation of the Japanese version of the Geriatric Anxiety Scale. Psychogeriatrics 2023. [PMID: 37095633 DOI: 10.1111/psyg.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND This study developed a Japanese version of the Geriatric Anxiety Scale (GAS-J) and its short form (GAS-10-J) to evaluate anxiety in Japanese older adults and assess its psychometric properties using a cross-sectional design. METHODS A total of 331 community-dwelling older adult participants (208 men, 116 women, seven unknowns; mean age = 73.47 ± 5.17 years, range = 60-88 years) recruited from two Silver Human Resources Centres in the Kanto region, Japan, answered a set of self-report questionnaires. Of these respondents, 120 participated in a follow-up survey to evaluate test-retest reliability. RESULTS Confirmatory factor analysis suggested that, as with the original GAS, the GAS-J had a three-factor structure and the GAS-10-J had a unifactor structure with high standardised factor loadings. Test-retest correlations and internal consistency analyses indicated that these scales were reliable. Correlations between the GAS-J/GAS-10-J with the Geriatric Anxiety Inventory, Generalised Anxiety Disorder-7, Geriatric Depression Scale-15, World Health Organization-Five Well-Being Index, and Kihon Checklist were mostly consistent with our hypotheses, thereby supporting the construct validity of the GAS-J/GAS-10-J. CONCLUSIONS The findings indicate that the GAS-J and GAS-10-J have robust psychometric properties for assessing late-life anxiety in Japanese older adults. Further GAS-J studies are required for clinical groups.
Collapse
Affiliation(s)
- Masami Kashimura
- Faculty of Human Sciences, Department of Psychology, Tokiwa University, Ibaraki, Japan
| | - Kenichiro Ishizu
- Graduate School of Teacher Training Development, University of Toyama, Toyama, Japan
| | - Naomi Kokubo
- Institute for Quantum Medical Science, Quantum Life and Medical Science Directorate, National Institute for Quantum Science and Technology, Chiba, Japan
| | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| |
Collapse
|
6
|
Picconi L, Fairfield B, Sergi MR, Cataldi F, Padulo C, Brugnera A, Parisi G, Compare A, Gottschling J, Segal DL. Development and Validation of a Short Form of the Geriatric Anxiety Scale (GAS-12) among Italian Older Adults. Clin Gerontol 2022:1-17. [PMID: 36065753 DOI: 10.1080/07317115.2022.2120445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES We developed a new Italian short version of the Geriatric Anxiety Scale (GAS-12) and evaluated its psychometric properties. The GAS-12 specifically screens for anxiety symptoms in the Italian older adult population by identifying items that best discriminate anxiety in this population. METHODS In Study 1, we administered the full-length Italian translation of the GAS to 517 older adults and used item response theory to identify the most discriminating items and to develop the short form used in Study 2. In Study 2, we evaluated the functioning of the new short form of the questionnaire in a new sample of 427 older adults using Confirmatory factor analysis. RESULTS Analyses indicated 12 items that discriminated well between anxious and non-anxious participants and distributed along the latent continuum of each trait. The GAS-12 fits a three-factor structure. There was also evidence for convergent and divergent validity. CONCLUSIONS The Italian GAS-12 appears to be a useful instrument for the quantitative screening of anxiety in Italian older adults. CLINICAL IMPLICATIONS Anxiety imposes significant impairment thus making imperative the screening and assessment of anxiety symptoms. The GAS-12 is particularly indicated with limited time and many scales in a clinical assessment or research protocols.
Collapse
Affiliation(s)
- Laura Picconi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Beth Fairfield
- Department of Humanities Studies, University Federico II of Naples, Naples, Italy
| | - Maria Rita Sergi
- Department of Medicine and Aging Sciences, University of Chieti, Chieti, Italy
| | - Fedele Cataldi
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Caterina Padulo
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Agostino Brugnera
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Giulia Parisi
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Angelo Compare
- Department of Human and Social Sciences, University of Bergamo, Bergamo, Italy
| | - Juliana Gottschling
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, Colorado, USA
| |
Collapse
|
7
|
Carlucci L, Balestrieri M, Maso E, Marini A, Conte N, Balsamo M. Psychometric properties and diagnostic accuracy of the short form of the geriatric anxiety scale (GAS-10). BMC Geriatr 2021; 21:401. [PMID: 34193082 PMCID: PMC8243753 DOI: 10.1186/s12877-021-02350-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 12/17/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Leonardo Carlucci
- Department of Psychological Sciences, Health and Territory, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini, 31 66100, Chieti, Italy.
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, Udine, Italy
| | - Elisa Maso
- Psychiatric Clinic, Healthcare and University Integrated Trust, Udine, Italy
| | - Alessia Marini
- Department of Psychological Sciences, Health and Territory, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini, 31 66100, Chieti, Italy
| | - Nadia Conte
- Department of Psychological Sciences, Health and Territory, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini, 31 66100, Chieti, Italy
| | - Michela Balsamo
- Department of Psychological Sciences, Health and Territory, "G. d'Annunzio" University of Chieti-Pescara, via dei Vestini, 31 66100, Chieti, Italy
| |
Collapse
|
8
|
Li Z, Zhao X, Sheng A, Wang L. Item response analysis of the Geriatric Anxiety Inventory among the elderly in China: dimensionality and differential item functioning test. BMC Geriatr 2019; 19:313. [PMID: 31729965 PMCID: PMC6858656 DOI: 10.1186/s12877-019-1346-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 11/06/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Anxiety symptoms are pervasive among elderly populations around the world. The Geriatric Anxiety Inventory (the GAI) has been developed and widely used in screening those suffering from severe symptoms. Although debates about its dimensionality have been mostly resolved by Molde et al. (2019) with bifactor modeling, evidence regarding its measurement invariance across sex and somatic diseases is still missing. METHODS This study attempted to provide complemental evidence to the dimensionality debates of the GAI with Mokken scale analysis and to examine its measurement invariance across sex and somatic diseases by conducting differential item functioning (DIF) analysis among a sample of older Chinese adults. The data was from responses of a large representative sample (N = 1314) in the Chinese National Survey Data Archive, focusing on the mental health of elderly adults. RESULTS The results of Mokken scale analysis confirmed the unidimensionality of the GAI, and DIF analysis indicated measurement invariance of this inventory across individuals with different sex and somatic diseases, with just a few items exhibiting item bias but all of them negligible. CONCLUSIONS All these findings supported the use of this inventory among Chinese elders to screen anxiety symptoms and to make comparisons across sex and somatic diseases.
Collapse
Affiliation(s)
- Zhongquan Li
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China.
| | - Xia Zhao
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China
| | - Ang Sheng
- School of Social and Behavioral Sciences, Nanjing University, 163 Xianlin Avenue, Qixia District, Nanjing, 210023, Jiangsu, China
| | - Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| |
Collapse
|
9
|
Gottschling J, Dörendahl J, Prell T, Karbach J, Bunz M, Kindermann I, Moussaoui J, Spinath FM, Wedegärtner S, Witte OW, Greiff S, Segal DL. Measuring Anxiety in Older Adults: Development, Diagnostic Accuracy, and Preliminary Validation of a Short-Form of the German Geriatric Anxiety Scale (GAS-G-SF). J Pers Assess 2019; 102:196-204. [PMID: 31625412 DOI: 10.1080/00223891.2019.1677679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Anxiety symptoms and anxiety disorders are highly prevalent among older adults, and are associated with considerable distress, functional impairment, and burden. Also, there is growing need for brief instruments to measure anxiety symptoms in primary care and geriatric medical settings. Therefore, the current study focuses on the development and psychometric evaluation of a short-form of the Geriatric Anxiety Scale (GAS-G), a well-established anxiety instrument for use with older adults. Study 1 draws on the original data from the GAS-G validation study (N = 242) to develop the short-form (GAS-G-SF) and determines whether the results replicate with the short-form. Study 2 extends the validation of the GAS-G-SF to a clinical sample (N = 156; 62 patients with heart disease, 94 patients with Parkinson's disease). Overall, the GAS-G-SF showed promising psychometric properties in terms of internal consistency and validity. Also, the GAS-G-SF showed good discriminatory power based on receiver operating characteristic curve analysis in both studies. These results support the utility of the GAS-G-SF as a brief assessment measure for anxiety.
Collapse
Affiliation(s)
| | - Jan Dörendahl
- Cognitive Science & Assessment, University of Luxembourg, Luxembourg
| | - Tino Prell
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Julia Karbach
- Department of Psychology, University of Koblenz-Landau, Landau, Germany
| | - Maxie Bunz
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany.,Department of Environmental Medicine, German Environment Agency, Berlin, Germany
| | - Ingrid Kindermann
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | | | - Frank M Spinath
- Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Sonja Wedegärtner
- Clinic for Internal Medicine III, Cardiology, Angiology, & Intensive Care Medicine, Saarland University Hospital, Homburg, Germany
| | - Otto W Witte
- Department of Neurology, Jena University Hospital, Jena, Germany.,Center for Healthy Ageing, Jena University Hospital, Jena, Germany
| | - Samuel Greiff
- Cognitive Science & Assessment, University of Luxembourg, Luxembourg
| | - Daniel L Segal
- Psychology Department, University of Colorado at Colorado Springs, Colorado Springs, CO USA
| |
Collapse
|
10
|
Gatti A, Gottschling J, Brugnera A, Adorni R, Zarbo C, Compare A, Segal DL. An investigation of the psychometric properties of the Geriatric Anxiety Scale (GAS) in an Italian sample of community-dwelling older adults. Aging Ment Health 2018; 22:1170-1178. [PMID: 28675312 DOI: 10.1080/13607863.2017.1347141] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
BACKGROUND The Italian older adult population is increasing and psychiatric problems, such as anxiety among older adults, represent major challenges for public welfare. A strong need exists for instruments specifically developed to assess anxiety among Italian older adults. The Geriatric Anxiety Scale (GAS) is a 30-item self-report questionnaire that evaluates anxiety among older adults and has demonstrated strong psychometric properties in several languages. OBJECTIVE The present study aimed to validate an Italian version of the GAS (GAS-I) and to preliminarily investigate its psychometric properties. METHOD The translation was performed using a five-stage procedure, following a forward-back process and paying attention to cultural issues. The GAS-I was administered to 231 community-dwelling older adults with other commonly-used questionnaires of anxiety, depression, and quality of life. RESULTS Results confirmed good psychometric qualities of the questionnaire. Confirmatory factor analyses evidenced a unidimensional structure of the GAS-I, in accordance with other validated versions. Convergent and discriminant validity were highly satisfactory. The three-factor model also provided an acceptable fit to the data. Receiver operating characteristic curve analyses revealed good discriminatory power of the GAS-I. CONCLUSION These findings demonstrate that the GAS-I is a reliable and valid self-report questionnaire to measure anxiety among Italian older adults.
Collapse
Affiliation(s)
- Alessia Gatti
- a Human Factors and Technology in Healthcare , University of Bergamo , Bergamo , Italy
| | | | - Agostino Brugnera
- c Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy
| | - Roberta Adorni
- c Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy.,d Department of Engineering and Applied Science , University of Bergamo , Bergamo , Italy
| | - Cristina Zarbo
- c Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy
| | - Angelo Compare
- a Human Factors and Technology in Healthcare , University of Bergamo , Bergamo , Italy.,c Department of Human and Social Sciences , University of Bergamo , Bergamo , Italy
| | - Daniel L Segal
- e Department of Psychology , University of Colorado at Colorado Springs , Colorado Springs , CO , USA
| |
Collapse
|
11
|
Picconi L, Balsamo M, Palumbo R, Fairfield B. Testing Factor Structure and Measurement Invariance Across Gender With Italian Geriatric Anxiety Scale. Front Psychol 2018; 9:1164. [PMID: 30026718 PMCID: PMC6042251 DOI: 10.3389/fpsyg.2018.01164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/18/2018] [Indexed: 11/13/2022] Open
Abstract
Late-life anxiety is an increasingly relevant psychiatric condition that often goes unnoticed and/or untreated compared to anxiety in younger populations. Consequently, assessing the presence and severity of clinical anxiety in older adults an important challenge for researchers and clinicians alike. The Geriatric Anxiety Scale is a 30-item geriatric-specific measure of anxiety severity, grouped in three subscales (Somatic, Affective, and Cognitive), with solid evidence for the reliability and validity of its scores in clinical and community samples. Translated into several languages, it has been proven to have strong psychometric properties. In Italy only one recent preliminarily investigative study has appeared on its psychometric properties. However, sample data was largely collected from one specific Italian region (Lombardy) alone. Here, our aim in testing the items of the GAS in a sample of 346 healthy subjects (50% females; 52% from Southern Italy), with mean age of 71.74 years, was 2-fold. First, we aimed to determine factor structure in a wider sample of Italian participants. Confirmatory factor analysis showed that the GAS fits an originally postulated three-factor structure reasonably well. Second, results support gender invariance, entirely supported at the factorial structure, and at the intercept level. Latent means can be meaningfully compared across gender groups. Whereas the means of F1 (Somatic) and F3 (Affective) for males were significantly different from those for females, the means for F2 (Cognitive) were not. More specifically, in light of the negative signs associated with these statistically significant values, the finding showed that F1 and F3 for males appeared to be less positive on average than females. Overall, the GAS displayed acceptable convergent validity with matching subscales highly correlated, and satisfactory internal discriminant validity with lower correlations between non-matching subscales. Implications for clinical practice and research are discussed.
Collapse
Affiliation(s)
- Laura Picconi
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Michela Balsamo
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy
| | - Rocco Palumbo
- Department of Neurology, Boston University, Boston, MA, United States
| | - Beth Fairfield
- Department of Psychological, Health & Territorial Sciences, University of Chieti, Chieti, Italy.,Centro Scienze dell'Invecchiamento e Medicina Traslazionale, University of Chieti, Chieti, Italy
| |
Collapse
|
12
|
Lin XL, Lu DL, Gottschling J, Segal DL, Tang SY. Validation of a Chinese Version of the Geriatric Anxiety Scale Among Community-Dwelling Older Adults in Mainland China. J Cross Cult Gerontol 2017; 32:57-70. [PMID: 27541156 DOI: 10.1007/s10823-016-9302-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The Geriatric Anxiety Scale (GAS) was developed as an international screening instrument for anxiety in older adults. The aims of the present study were to translate the GAS into Chinese and to subsequently evaluate the preliminary psychometric properties of the Chinese version of the GAS (GAS-C) among community-dwelling Chinese older adults. The translation of the GAS into Chinese was developed through a translation and back translation process. A sample of 206 community-dwelling older adults (51.9 % men, Mean age = 70.70 years, SD = 8.15 years) completed the GAS-C, the Beck Anxiety Inventory (BAI), the Geriatric Depression Scale (GDS) and the Pittsburgh Sleep Quality Index (PSQI). A confirmatory factor analysis was conducted to examine the factor structure of the GAS-C. Internal consistency and convergent validity were used to evaluate the psychometric properties of the translated measure. The factor analyses were in support of a unidimensional factor model of the GAS-C in this Chinese sample, and the item-total correlations for all 25 items ranged from 0.40 to 0.83. The internal consistency for the GAS-C total score was excellent (α = 0.92). The GAS-C total score were significantly and strongly correlated with the BAI (r = 0.86), the GDS (r = 0.78) and the PSQI (r = 0.63), which indicated good convergent validity of the GAS-C. The GAS-C appears to be a reliable and valid screening instrument to assess anxiety symptoms among community-dwelling older adults in mainland China.
Collapse
Affiliation(s)
- Xiao-Ling Lin
- Xiangya Nursing School of Central South University, Tongzipo Road No172, Changsha, Hunan, 410013, People's Republic of China
| | - Da-Li Lu
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen, Fujian, People's Republic of China
| | | | - Daniel L Segal
- Department of Psychology, University of Colorado at Colorado Springs, Colorado Springs, CO, 80918, USA.
| | - Si-Yuan Tang
- Xiangya Nursing School of Central South University, Tongzipo Road No172, Changsha, Hunan, 410013, People's Republic of China.
| |
Collapse
|