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Pan RM, Chang HJ, Chi MJ, Wang CY, Chuang YH. The traditional Chinese version of the Geriatric Anxiety Inventory: Psychometric properties and cutoff point for detecting anxiety. Geriatr Nurs 2024; 58:438-445. [PMID: 38908039 DOI: 10.1016/j.gerinurse.2024.06.008] [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: 02/02/2024] [Revised: 05/27/2024] [Accepted: 06/03/2024] [Indexed: 06/24/2024]
Abstract
The study aimed to translate the Geriatric Anxiety Inventory into traditional Chinese (GAI-TC), examine its psychometric properties, and identify the optimal cutoff point. This research recruited 337 older adults from two community activity centers. Structured questionnaires were used, including demographic information and characteristics, the GAI-TC, and the State-Trait Anxiety Inventory (STAI). Cronbach's α of the GAI-TC was 0.93. The intraclass correlation coefficient was 0.90. The content validity index was 1.0. An exploratory factor analysis revealed that three factors in the GAI-TC, including cognition anxiety, impact of anxiety, and somatic anxiety, explained 59.46 % of the variance. The criterion-related validity showed a significant positive correlation between the GAI-TC and STAI, with an optimal cutoff of 9/10 for detecting anxiety in older persons living in the community. The GAI-TC had good reliability and validity and can provide professionals with a tool for the early identification of anxiety among older adults.
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Affiliation(s)
- Rou-May Pan
- Department of Nursing, National Taiwan University Hospital, 7, Zhongshan S. Rd., Zhongzheng Dist., Taipei 100225, Taiwan
| | - Hsiu-Ju Chang
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, 155 Linong St., Sec. 2, Taipei 112304, Taiwan; College of Nursing, Efficient Smart Care Research Center, National Yang Ming Chiao Tung University,155 Linong St., Sec. 2, Taipei City 112304, Taiwan
| | - Mei-Ju Chi
- School of Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, 250 Wu-Xing St., Taipei 11031, Taiwan; International PhD Program in Gerontology and Long-Term Care, College of Nursing, Taipei Medical University, 250 Wu-Xing St., Taipei 11031, Taiwan
| | - Chih-Yu Wang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Xing St., Xinyi District, Taipei 11031, Taiwan
| | - Yeu-Hui Chuang
- School of Nursing, College of Nursing, Taipei Medical University, 250 Wu-Xing St., Xinyi District, Taipei 11031, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, 111 Xinglong Rd, Sec. 3. Wenshan District, Taipei 11696, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, 111 Xinglong Rd, Sec. 3. Wenshan District, Taipei 11696, Taiwan.
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Kryza-Lacombe M, Kassel MT, Insel PS, Rhodes E, Bickford D, Burns E, Butters MA, Tosun D, Aisen P, Raman R, Landau S, Saykin AJ, Toga AW, Jack CR, Koeppe R, Weiner MW, Nelson C, Mackin RS. Anxiety in late-life depression: Associations with brain volume, amyloid beta, white matter lesions, cognition, and functional ability. Int Psychogeriatr 2024:1-12. [PMID: 38268483 PMCID: PMC11269525 DOI: 10.1017/s1041610224000012] [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] [Indexed: 01/26/2024]
Abstract
OBJECTIVES Late-life depression (LLD) is common and frequently co-occurs with neurodegenerative diseases of aging. Little is known about how heterogeneity within LLD relates to factors typically associated with neurodegeneration. Varying levels of anxiety are one source of heterogeneity in LLD. We examined associations between anxiety symptom severity and factors associated with neurodegeneration, including regional brain volumes, amyloid beta (Aβ) deposition, white matter disease, cognitive dysfunction, and functional ability in LLD. PARTICIPANTS AND MEASUREMENTS Older adults with major depression (N = 121, Ages 65-91) were evaluated for anxiety severity and the following: brain volume (orbitofrontal cortex [OFC], insula), cortical Aβ standardized uptake value ratio (SUVR), white matter hyperintensity (WMH) volume, global cognition, and functional ability. Separate linear regression analyses adjusting for age, sex, and concurrent depression severity were conducted to examine associations between anxiety and each of these factors. A global regression analysis was then conducted to examine the relative associations of these variables with anxiety severity. RESULTS Greater anxiety severity was associated with lower OFC volume (β = -68.25, t = -2.18, p = .031) and greater cognitive dysfunction (β = 0.23, t = 2.46, p = .016). Anxiety severity was not associated with insula volume, Aβ SUVR, WMH, or functional ability. When examining the relative associations of cognitive functioning and OFC volume with anxiety in a global model, cognitive dysfunction (β = 0.24, t = 2.62, p = .010), but not OFC volume, remained significantly associated with anxiety. CONCLUSIONS Among multiple factors typically associated with neurodegeneration, cognitive dysfunction stands out as a key factor associated with anxiety severity in LLD which has implications for cognitive and psychiatric interventions.
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Affiliation(s)
- Maria Kryza-Lacombe
- Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Michelle T. Kassel
- Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Philip S. Insel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Emma Rhodes
- Mental Illness Research Education and Clinical Centers, Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - David Bickford
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Emily Burns
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - Meryl A. Butters
- Department of Psychiatry Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Duygu Tosun
- Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Paul Aisen
- University of Southern California, Los Angeles, CA, USA
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, CA, USA
| | - Rema Raman
- University of Southern California, Los Angeles, CA, USA
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, CA, USA
| | - Susan Landau
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA USA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences and the Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Arthur W. Toga
- Laboratory of Neuro Imaging, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Robert Koeppe
- Department of Radiology, University of Michigan, Ann Arbor, USA
| | - Michael W. Weiner
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Veterans Affairs Medical Center, San Francisco, CA, USA
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Craig Nelson
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
| | - R. Scott Mackin
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, CA, USA
- Veterans Affairs Medical Center, San Francisco, CA, USA
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Schwabenbauer AK, Merladet J, Metzner N, Salib B, Siffert K. Adapting Measurement-Based Care to VA Home-Based Primary Care Mental Health Treatment: A Quality Improvement Project. Clin Gerontol 2024:1-10. [PMID: 38226906 DOI: 10.1080/07317115.2024.2304889] [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: 01/17/2024]
Abstract
OBJECTIVES This quality improvement project sought to develop guidance for Home-Based Primary Care (HPBC) Mental Health (MH) clinicians on integrating Measurement-Based Care (MBC) into their practice and gain participating psychologists' feedback on their experience using MBC for treating mental health concerns with HBPC Veterans. METHODS Based on feedback from the HBPC MH community and in consultation with national leadership, a workgroup of HBPC psychologists developed a guide tailoring MBC to HBPC Veterans. Eight HBPC psychologists piloted the adapted MBC approach with 53 Veterans. Participating psychologists provided feedback on measure administration, Veterans' responses to MBC, and perceived benefits and challenges. RESULTS Pilot participants' feedback suggested that MBC can be a highly useful tool for delivering mental health services in HBPC, although feedback varied about specific MBC measures. Qualitative feedback was primarily positive, but participants noted challenges based on the nature of the presenting problem and Veteran-specific characteristics. CONCLUSIONS Findings indicate that MBC can be utilized with appropriate HBPC Veterans and has the potential to benefit care. Further research is needed to clarify factors that enhance or reduce MBC's utility within HBPC. CLINICAL IMPLICATIONS HBPC MH providers identified MBC as a useful tool particularly when adapted to meet the needs of HBPC Veterans.
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Affiliation(s)
| | - John Merladet
- Behavioral Health, Orlando VA Medical Center, Orlando, Florida, USA
| | - Neil Metzner
- Behavioral Health, White River Junction VA Medical Center, White River Junction, Vermont, USA
| | - Brea Salib
- Behavioral Health, Durham VA Health Care System, Durham, North Carolina, USA
| | - Kevin Siffert
- Behavioral Health, Michael E. DeBakey VA Medical Center, Houston, Texas, USA
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Zhai T, Bailey PE, Rogers KD, Kneebone II. Validation of the Geriatric Anxiety Inventory in younger adults. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2022. [DOI: 10.1177/01650254211064348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the psychometric properties of the Geriatric Anxiety Inventory (GAI) in younger adults. Participants were 212 younger adults age M = 22 (range = 17–53) years. They completed a demographic information questionnaire and self-report measures: the GAI, the Depression Anxiety Stress Scales (DASS), the Generalized Anxiety Disorder–7 (GAD-7), the Patient Health Questionnaire–9 (PHQ-9), the Penn State Worry Questionnaire (PSWQ), and the Worry Behaviors Inventory (WBI). Data from the GAI were collected at two time points, one week apart, and data from other self-report measures were collected once via Qualtrics, an online survey platform. The internal consistency and test–retest score reliability of the GAI were excellent. It had good congruent validity with other anxiety measures, limited divergent validity with depression measures, and sound convergent validity with worry measures. The GAI showed good discrimination between probable cases and noncases of generalized anxiety disorder (participants who scored ⩾8 on the GAD-7) and its optimal cutoff score for probable cases of GAD was ⩾12. A unidimensional component structure of the GAI best fit this study’s data. This study has provided preliminary evidence that the GAI is reliable and valid for use in an Australian sample of younger adults.
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Affiliation(s)
- Tina Zhai
- University of Technology Sydney, Australia
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Molde H, Nordhus IH, Torsheim T, Engedal K, Bendixen AB, Byrne GJ, Márquez-González M, Losada A, Feng L, Ow EKT, Pisitsungkagarn K, Taephant N, Jarukasemthawee S, Champagne A, Landreville P, Gosselin P, Ribeiro O, Diefenbach GJ, Blank K, Beaudreau SA, Laks J, de Araújo NB, Fonseca RP, Kochhann R, Camozzato A, van den Brink RHS, Fluiter M, Naarding P, Pelzers LPRM, Lugtenburg A, Oude Voshaar RC, Pachana NA. A Cross-National Analysis of the Psychometric Properties of the Geriatric Anxiety Inventory. J Gerontol B Psychol Sci Soc Sci 2021; 75:1475-1483. [PMID: 30624724 DOI: 10.1093/geronb/gbz002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/07/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Assessing late-life anxiety using an instrument with sound psychometric properties including cross-cultural invariance is essential for cross-national aging research and clinical assessment. To date, no cross-national research studies have examined the psychometric properties of the frequently used Geriatric Anxiety Inventory (GAI) in depth. METHOD Using data from 3,731 older adults from 10 national samples (Australia, Brazil, Canada, The Netherlands, Norway, Portugal, Spain, Singapore, Thailand, and United States), this study used bifactor modeling to analyze the dimensionality of the GAI. We evaluated the "fitness" of individual items based on the explained common variance for each item across all nations. In addition, a multigroup confirmatory factor analysis was applied, testing for measurement invariance across the samples. RESULTS Across samples, the presence of a strong G factor provides support that a general factor is of primary importance, rather than subfactors. That is, the data support a primarily unidimensional representation of the GAI, still acknowledging the presence of multidimensional factors. A GAI score in one of the countries would be directly comparable to a GAI score in any of the other countries tested, perhaps with the exception of Singapore. DISCUSSION Although several items demonstrated relatively weak common variance with the general factor, the unidimensional structure remained strong even with these items retained. Thus, it is recommended that the GAI be administered using all items.
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Affiliation(s)
- Helge Molde
- Department of Clinical Psychology, University of Bergen, Norway
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, University of Bergen, Norway.,Department of Behavioural Sciences in Medicine, University of Oslo, Norway
| | | | - Knut Engedal
- Department of Geriatric Psychiatry, Diakonhjemmet Hospital, Oslo, Norway and Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Toensberg, Norway
| | - Anette Bakkane Bendixen
- Department of Geriatric Psychiatry, Diakonhjemmet Hospital, Oslo, Norway and Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Toensberg, Norway
| | - Gerard J Byrne
- School of Clinical Medicine, The University of Queensland, Brisbane, Australia
| | - María Márquez-González
- Biological and Health Psychology Department, Faculty of Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Andres Losada
- Department of Medicine, Clinical Psychology Area, Universidad Rey Juan Carlos, Madrid, Spain
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elisabeth Kuan Tai Ow
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | | | | | | | | | | | | | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Department of Education and Psychology, Aveiro University, Portugal
| | | | - Karen Blank
- Anxiety Disorders Center, Institute of Living, Hartford, Connecticut
| | - Sherry A Beaudreau
- Sierra Pacific Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System and Psychiatry and Behavioral Sciences, Stanford University of Medicine, Palo Alto, California
| | - Jerson Laks
- Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Brazil
| | | | - Rochele Paz Fonseca
- Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Renata Kochhann
- Graduate Program in Psychology, Pontifical Catholic University of Rio Grande do Sul (PUCRS), Brazil
| | - Analuiza Camozzato
- Universidade Federal de Ciências da Saúde de Porto Alegre UFCSPA, Brazil
| | - Rob H S van den Brink
- Rob Giel Research center (RGOc), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mario Fluiter
- Mental Health Center GGZ Noord-Holland Noord, Heerhugowaard, The Netherlands
| | - Paul Naarding
- GGNet Mental Health, Division of Old Age Psychiatry, Warnsveld & Apeldoorn, The Netherlands
| | | | | | - Richard C Oude Voshaar
- Rob Giel Research center (RGOc), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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Lee GJ, Do C, Suhr JA. Effects of personal dementia exposure on subjective memory concerns and dementia worry. AGING NEUROPSYCHOLOGY AND COGNITION 2020; 28:855-870. [DOI: 10.1080/13825585.2020.1836119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Grace J. Lee
- Department of Psychology, Ohio University Athens, OH, USA
| | - Cardinal Do
- Department of Psychology, Ohio University Athens, OH, USA
| | - Julie A. Suhr
- Department of Psychology, Ohio University Athens, OH, USA
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Abstract
The Geriatric Anxiety Inventory (GAI) and its short form (GAI-SF) are self-reported scales used internationally to assess anxiety symptoms in older adults. In this study, we conducted the first critical comprehensive review of these scales' psychometric properties. We rated the quality of 31 relevant studies with the COSMIN checklist. Both the GAI and GAI-SF showed adequate internal consistency and test-retest reliability. Convergent validity indices were highest with generalized anxiety measures; lowest with instruments relating to somatic symptoms. We detected substantial overlap with depression measures. While there was no consensus on the GAI's factorial structure, we found the short version to be unidimensional. Although we found good sensitivity and specificity for detecting anxiety, cut-off scores varied. The GAI and GAI-SF are relevant instruments showing satisfactory psychometric properties; to broaden their use, however, some psychometric properties warrant closer examination. This review calls attention to weaknesses in the methodological quality of the studies.
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Assessment of anxiety in older adults: psychometric properties and relationships with self-reported functional impairment. Int Psychogeriatr 2020; 32:505-513. [PMID: 31455449 DOI: 10.1017/s1041610219001145] [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: 11/07/2022]
Abstract
OBJECTIVE The current study aimed to examine the psychometric properties of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and the Geriatric Anxiety Scale (GAS). This study also aimed to determine the relationships of these measures with two measures of functional ability and impairment: the Barkley Functional Impairment Scale (BFIS) and the Everyday Cognition Scale (E-Cog). DESIGN Confirmatory factor analyses (CFA) were used to analyze the factor structures of the GAI and GAS in older adults. Tests for dependent correlations were used to examine the relationship between anxiety scales and functioning. SETTING Amazon's Mechanical Turk. PARTICIPANTS 348 participants (aged 55-85, M= 62.75 (4.8), 66.5% female) with no history of psychosis or traumatic brain injury. RESULTS CFAs supported the previously demonstrated bifactor solution for the GAI. For the GAS, the previously demonstrated three-factor model demonstrated a good-to-excellent fit. Given the high correlation between the cognitive and affective factors (r =.89), a bifactor solution was also tested. The bifactor model of the GAS was found to be primarily unidimensional. Tests for dependent correlations revealed that the GAS demonstrated stronger relationships with measures of self-reported functional impairment than the GAI. CONCLUSIONS The current study provides further psychometric validation of the factor structure of two geriatric anxiety measures in an older adult sample. The results support previous work completed on the GAI and the GAS. The GAS was more strongly correlated with self-reported functional impairment than the GAI, which may reflect differences in content in the two measures.
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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.
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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
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Bandari R, Heravi-Karimooi M, Miremadi M, Mohebbi L, Montazeri A. The Iranian version of geriatric anxiety inventory (GAI-P): a validation study. Health Qual Life Outcomes 2019; 17:118. [PMID: 31296228 PMCID: PMC6624870 DOI: 10.1186/s12955-019-1176-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 06/06/2019] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Anxiety is one of the most common mental health problems experienced by the elderly that affects quality of life. This study aimed to assess the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-P) in order to provide a valid instrument for measuring anxiety in this population. METHODS Forward-backward translation was used to translate the Geriatric Anxiety Inventory from English into Persian and was tested by 10 elderly to assess its face validity. Then a sample of elderly people attending health centers in Dezful, Iran completed the questionnaire. Validity was assessed using both exploratory and confirmatory factors analysis, known-groups comparison (abused and non-abused elderly) also was administered. The internal consistency of the instrument was assessed using Kuder-Richardson 20 coefficients (KR-20). Afterwards, the reliability and validity through assessing the correlation between the Persian version of the GAI-P and the SF-36, were measured. RESULTS In all 720 elderly completed the questionnaire. Of these data from 420 elderly were used for exploratory factor analysis and the data from the remaining 300 elderly were used for confirmatory factor analysis. The exploratory factor analysis showed a three-factor solution (cognitive, arousal and somatic) for the questionnaire that jointly explained 59.48% of the overall variance observed. The confirmatory factor analysis supported the three-factor solution and the second-order latent factor model. The findings indicated a positive and significant correlation between the two measures lending support to its concurrent validity (r = 0.67, p < .001).Ultimately, the Geriatric Anxiety Inventory was found to have a favorable internal consistency. CONCLUSION This study confirmed that the GAI-P is a valid measure of anxiety in elderly population and now can be used in geriatric studies in Iran.
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Affiliation(s)
- Razieh Bandari
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Majideh Heravi-Karimooi
- Elderly Care Research Center, College of Nursing & Midwifery, Shahed University, Tehran, Iran
| | - Mojgan Miremadi
- Faculty of Nursing Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Mohebbi
- Department of Health, Dezful University of Medical Sciences, Dezful, Iran
| | - Ali Montazeri
- Population Health Group Health Metrics Research Centre, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran
- Faculty of Humanity Sciences, University of Science & Culture ACECR, Tehran, Iran
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Miranda-Castillo C, Contreras D, Garay K, Martínez P, León-Campos MO, Farhang M, Morán J, Fernández-Fernández V. Validation of the Geriatric Anxiety Inventory in Chilean older people. Arch Gerontol Geriatr 2019; 83:81-85. [PMID: 30974400 DOI: 10.1016/j.archger.2019.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 03/05/2019] [Accepted: 03/25/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Currently in Chile there is a lack of validated tools for measuring anxiety in the elderly population. Considering this, the purpose of this study was to validate the Geriatric Anxiety Inventory (GAI) in the country. METHOD An analysis of the psychometric properties of the GAI was carried out, using a non-clinical sample of 301 older adults in the Metropolitan and Valparaíso regions of Chile. Older people were asked about anxiety, rumination, depression, well-being and sociodemographic data. RESULTS An excellent internal reliability was obtained with a Cronbach score of 0.931. An adequate convergent validity was observed with the Depression scales (CES-D) (Rho = 0.549, p < .01), Rumination (RSS) (Rho = 0.618; p < 0.01) and Experiential avoiding (Rho = 0.485; p < 0.01). On the other hand, the discriminant validity of the psychological well-being scale presented a negative correlation of Rho = -0.699 (p < 0.01). Finally, and Exploratory Factor Analysis was made, revealing a one-dimensional model of the instrument. CONCLUSION The Geriatric Anxiety Inventory has very good psychometric properties measuring anxiety in elderly people, being an adequate instrument for the screening of anxiety on this population.
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Affiliation(s)
- Claudia Miranda-Castillo
- Universidad Andres Bello, Faculty of Nursing, Sazié 2212, Santiago, Chile; Millennium Institute for Research in Depression and Personality, Av. Vicuña Mackenna 4860, Macul, Santiago, Chile.
| | - Daniel Contreras
- School of Psychology, Universidad de Valparaíso, Av. Brasil 2140, Valparaíso, Chile
| | - Karin Garay
- School of Psychology, Universidad de Valparaíso, Av. Brasil 2140, Valparaíso, Chile
| | - Paula Martínez
- School of Psychology, Universidad de Valparaíso, Av. Brasil 2140, Valparaíso, Chile
| | - María O León-Campos
- Millennium Institute for Research in Depression and Personality, Av. Vicuña Mackenna 4860, Macul, Santiago, Chile
| | - Maryam Farhang
- Millennium Institute for Research in Depression and Personality, Av. Vicuña Mackenna 4860, Macul, Santiago, Chile
| | - Javier Morán
- Millennium Institute for Research in Depression and Personality, Av. Vicuña Mackenna 4860, Macul, Santiago, Chile; School of Psychology, Universidad de Valparaíso, Av. Brasil 2140, Valparaíso, Chile
| | - Virginia Fernández-Fernández
- Psychology of Personality, Evaluation and Psychological Treatment Department, Faculty of Psychology, UNED, C/ Juan del Rosal 10, 28040, Madrid, Spain
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Larouche E, Hudon C, Goulet S. Mindfulness mechanisms and psychological effects for aMCI patients: A comparison with psychoeducation. Complement Ther Clin Pract 2018; 34:93-104. [PMID: 30712752 DOI: 10.1016/j.ctcp.2018.11.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 10/08/2018] [Accepted: 11/06/2018] [Indexed: 10/27/2022]
Abstract
Amnestic mild cognitive impairment (aMCI), an Alzheimer's disease prodrome, is characterized by cognitive and psychological symptoms, the latter aggravating prognosis. A mindfulness-based intervention (MBI) represents a promising non-pharmacological framework for Alzheimer's disease prevention. The Monitoring + Acceptance Theory (MAT) postulates that MBI improves cognition through monitoring, and psychological well-being, through acceptance. This single-blind preliminary randomized-controlled study investigated the effects of a MBI on anxio-depressive symptoms, quality of life, and memory, compared to a psychoeducation-based intervention in older adults with aMCI. The contribution of MAT components and of ruminations' reduction to intervention efficacy were examined. Participants assigned to both conditions experienced similar benefits regarding anxio-depressive symptoms and aging-related quality of life. General quality of life and memory remained unchanged. A partial support of the MAT and of ruminations reduction to the MBI's efficacy was found. The findings provide new insights on the effects and mechanisms of a MBI on aMCI symptoms.
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Affiliation(s)
- E Larouche
- École de psychologie, Université Laval, Canada; Centre de Recherche CERVO Brain Research Center, Canada
| | - C Hudon
- École de psychologie, Université Laval, Canada; Centre de Recherche CERVO Brain Research Center, Canada
| | - S Goulet
- École de psychologie, Université Laval, Canada; Centre de Recherche CERVO Brain Research Center, Canada.
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Balsamo M, Cataldi F, Carlucci L, Fairfield B. Assessment of anxiety in older adults: a review of self-report measures. Clin Interv Aging 2018; 13:573-593. [PMID: 29670342 PMCID: PMC5896683 DOI: 10.2147/cia.s114100] [Citation(s) in RCA: 144] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
With increasing numbers of older adults in the general population, anxiety will become a widespread problem in late life and one of the major causes of health care access contributing to high societal and individual costs. Unfortunately, the detection of anxiety disorders in late life is complicated by a series of factors that make it different from assessment in younger cohorts, such as differential symptom presentation, high comorbidity with medical and mental disorders, the aging process, and newly emergent changes in life circumstances. This review covers commonly and currently used self-report inventories for assessing anxiety in older adults. For each tool, psychometric data is investigated in depth. In particular, information about reliability, validity evidence based on data from clinical and nonclinical samples of older adults, and availability of age-appropriate norms are provided. Finally, guidance for clinical evaluation and future research are proposed in an effort to highlight the importance of clinical assessment in the promotion of clinically relevant therapeutic choices.
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Affiliation(s)
- Michela Balsamo
- Department of Psychological, Health, and Territorial Sciences, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Fedele Cataldi
- Department of Psychological, Health, and Territorial Sciences, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Leonardo Carlucci
- Department of Psychological, Health, and Territorial Sciences, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Beth Fairfield
- Department of Psychological, Health, and Territorial Sciences, Gabriele d'Annunzio University of Chieti-Pescara, Chieti, Italy
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Bakkane Bendixen A, Hartberg CB, Selbæk G, Engedal K. Symptoms of Anxiety in Older Adults with Depression, Dementia, or Psychosis: A Principal Component Analysis of the Geriatric Anxiety Inventory. Dement Geriatr Cogn Disord 2018; 42:310-322. [PMID: 27811466 DOI: 10.1159/000452272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/06/2016] [Indexed: 11/19/2022] Open
Abstract
AIMS The primary aim of this study was to examine anxiety symptoms as measured by the Geriatric Anxiety Inventory (GAI) in older patients with depression, dementia, or psychotic disorders. The secondary aim was to conduct a principal component analysis (PCA) of the GAI and to examine whether its subscales differ between the 3 disorders. METHODS We included data from 428 patients who were admitted to a department of geriatric psychiatry and examined according to a standardized protocol. The GAI was used to measure current anxiety symptoms. RESULTS The GAI symptoms occurred more frequently in the group with depression than in the other 2 groups. The PCA of the GAI with oblimin rotation resulted in a 2-component solution, labelled as "worries" (explained variance 46.3%, Cronbach's α 0.92) and "physical symptoms" (explained variance 7.1%, Cronbach's α 0.85). CONCLUSION The results indicate that in old age, anxiety is especially prevalent in depression. The 2-component solution indicates that the GAI measures 2 different aspects of anxiety with different symptomatology.
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Champagne A, Landreville P, Gosselin P, Carmichael PH. Psychometric properties of the French Canadian version of the Geriatric Anxiety Inventory. Aging Ment Health 2018; 22:40-45. [PMID: 27656951 DOI: 10.1080/13607863.2016.1226767] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Geriatric Anxiety Inventory (GAI) and a short form of this instrument (GAI-SF) were developed to assess the severity of anxiety symptoms in older adults in order to compensate for the lack of validated screening tools adapted to the elderly population. This study examined the psychometric properties of the French Canadian version of the GAI, in its complete (GAI-FC) and short form (GAI-FC-SF). METHOD A total of 331 community-dwelling seniors between 65 and 92 years old participated in this study. RESULTS Both the GAI-FC and the GAI-FC-SF have sound psychometric properties with, respectively, a high internal consistency (α = .94 and .83), an adequate convergent validity (r = .50 to .86 with instruments known to evaluate constructs similar to the GAI or related to anxiety), a good test-retest reliability (r = .89 and .85), in addition to a single-factor structure. CONCLUSIONS The results support the use of both the GAI-FC and the GAI-FC-SF. The GAI-FC-SF seems to be an interesting alternative to the GAI-FC as a screening tool when time available for assessment is limited.
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Affiliation(s)
| | - Philippe Landreville
- a School of Psychology , Université Laval , Québec , Canada.,b Centre d'Excellence sur le Vieillissement , CHU de Quebec Research Center , Québec , Canada
| | - Patrick Gosselin
- c Department of Psychology , Université de Sherbrooke , Sherbrooke , Canada.,d Axis Adult Capacity Development , Institut universitaire de première ligne en santé et services sociaux - Centre intégré universitaire en santé et services sociaux de l'Estrie - CHUS (CIUSSS de l'Estrie - CHUS) , Sherbrooke , Canada
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16
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Abstract
BACKGROUND Due to previously reported mixed findings, there is a need for further empirical research on the factorial structure of the commonly used Geriatric Anxiety Inventory (GAI). Therefore, the psychometric properties of the GAI and its short form version (GAI-SF) were evaluated in a psychogeriatric mixed in-and-out patient sample (n = 543). METHODS Unidimensionality was tested using a bifactor analysis. Rasch modeling was used to assess scale properties. Sex, cognitive functioning and depressive symptoms were tested for differential item functioning (DIF). RESULTS The bifactor analysis identified an essential unidimensional (general) factor structure but also specific local factors. The general factor comprises all the 20 items as one factor, and the results showed that the variance in the general and specific factors (subscale) scores is best explained by the single general factor. These findings were demonstrated for both versions of the GAI. Furthermore, the Rasch models identified extensive item overlap, indicating redundant items in the full version of the GAI. The GAI-SF also seems to extract much of the same information as the full form. Test scores and items have the same meaning for older adults across different demographic status. CONCLUSION The findings support the use of a total sum score for both GAI and GAI-SF. Notably, when using the GAI-SF, no information is lost, in comparison with the full scale, thus, supporting the option of choosing the short form (version) when considered most appropriate in demanding clinical contexts.
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Guan M. Factor structure of the Chinese version of the geriatric anxiety inventory. Ann Gen Psychiatry 2016; 15:4. [PMID: 26823674 PMCID: PMC4730632 DOI: 10.1186/s12991-016-0092-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/07/2016] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND As China's population ages, the mental health of older people has been increasingly focused on by academic circles. PURPOSE The aim of this study was to identify the factor structure of the Chinese version of the geriatric anxiety inventory (GAI-CV). METHODS This study used data collected from Investigation on the anxiety symptoms of the elderly in the city of Beijing supported by scientific research fund project of Renmin University of China. Cronbach's α was used to test internal consistency reliability. Both confirmatory and exploratory factor analyses were performed separately for factor analysis. RESULTS 1318 subjects with mean age 71.35 ± 7.44 years (male 40.6 %) were involved. Principal components analysis revealed a three-factor structure of the GAI-CV. GAI-CV scales exhibited good internal consistency (Cronbach's α = 0.937) and a three-factor model fit the data well [comparative fit index (CFI) = 0.891, root mean square error of approximation (RMSEA) = 0.084]. CONCLUSIONS The Chinese version of the GAI appears to be reliable and valid to measure anxiety for elderly people in China.
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Affiliation(s)
- Ming Guan
- Family Issues Center, Xuchang University, Xuchang, China ; School of Business, Xuchang University, Xuchang, China
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Validation of the geriatric anxiety inventory in a duloxetine clinical trial for elderly adults with generalized anxiety disorder. Int Psychogeriatr 2015; 27:1533-9. [PMID: 25925598 DOI: 10.1017/s1041610215000381] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND The Generalized Anxiety Inventory (GAI) has been developed for use in the assessment of anxiety symptoms in older adults (≥ 65 years), but previous validation work has not examined the psychometric qualities of the instrument in relation to treatment. The objective of this study was to examine the performance of the GAI for its internal reliability, convergent and divergent validity, and its sensitivity to treatment. METHODS Elderly patients with generalized anxiety disorder (GAD) participated in a 10-week double-blind study of duloxetine treatment for patients with GAD. Anxiety symptoms were assessed with the Hamilton Anxiety Rating Scale (HAMA), the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales, and the GAI. Internal reliability of the GAI was assessed with Cronbach's α. Correlations among the HAMA, HADS, and GAI scores were analyzed to determine convergent and divergent validity. Patients were also compared on remission status using recommended cut-off scores for the GAI. RESULTS Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140) for 10 weeks acute therapy. The mean change on the GAI was significantly greater with duloxetine compared with placebo treatment (-8.36 vs. -4.96, respectively, p ≤ 0.001). The GAI demonstrated good internal consistency, good convergent and divergent validity, but suggested cut-off values for caseness with the GAI did not correspond to remission status as measured by the HAMA. CONCLUSIONS Within an elderly patient population with GAD, the GAI demonstrated sound psychometric qualities and sensitivity to change with treatment.
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Through a glass, only slightly less darkly: advances in measuring the influences of late-life anxiety. Am J Geriatr Psychiatry 2014; 22:1379-81. [PMID: 25459337 DOI: 10.1016/j.jagp.2014.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 09/16/2014] [Indexed: 11/23/2022]
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de Bruijn RFAG, Direk N, Mirza SS, Hofman A, Koudstaal PJ, Tiemeier H, Ikram MA. Anxiety is not associated with the risk of dementia or cognitive decline: the Rotterdam Study. Am J Geriatr Psychiatry 2014; 22:1382-90. [PMID: 24745561 DOI: 10.1016/j.jagp.2014.03.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Revised: 02/07/2014] [Accepted: 03/05/2014] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Anxiety and depression frequently co-occur in the elderly and in patients with dementia. Prior research has shown that depression is related to the risk of dementia, but the effect of anxiety on dementia remains unclear. We studied whether anxiety symptoms and anxiety disorders are associated with the risk of dementia and cognition. METHODS We studied 2,708 nondemented participants from the prospective, population-based Rotterdam Study who underwent the Hospital Anxiety and Depression Scale (HADS) (sample I, baseline 1993-1995) and 3,069 nondemented participants who underwent screening for anxiety disorders (sample II, baseline 2002-2004). In 1993-1995, anxiety symptoms were assessed using the HADS. In 2002-2004, anxiety disorders were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. In both study samples, participants were continuously monitored for dementia until January 1, 2011. Cognition was tested in 2002-2004 and at a follow-up visit in 2009-2011 in sample II only. RESULTS In sample I, 358 persons developed dementia, and in sample II, 248 persons developed dementia. We did not find an association with the risk of dementia for anxiety symptoms (hazard ratio 1.05, 95% confidence interval: 0.77-1.43, Wald statistic 0.08, p = 0.77, df = 1) or for anxiety disorders (hazard ratio 0.92, 95% confidence interval: 0.58-1.45, Wald statistic 0.14, p = 0.71, df = 1). We could demonstrate an association of anxiety disorders with poor cognition cross-sectionally, but this attenuated after additional adjustments. CONCLUSION Our findings do not offer evidence for an association between anxiety symptoms or anxiety disorders with the risk of dementia or with cognition. This suggests that anxiety is not a risk factor nor a prodrome of dementia in an elderly, community-dwelling population.
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Affiliation(s)
- Renée F A G de Bruijn
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands
| | - Nese Direk
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Saira Saeed Mirza
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Peter J Koudstaal
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Henning Tiemeier
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Child and Adolescent Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Psychiatry, Erasmus Medical Center, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Netherlands Consortium for Healthy Ageing, Leiden, The Netherlands.
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