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Atchison K, Wu P, Samii L, Walsh M, Ismail Z, Iaboni A, Goodarzi Z. Detection of anxiety symptoms and disorders in older adults: a diagnostic accuracy systematic review. Age Ageing 2024; 53:afae122. [PMID: 38954435 DOI: 10.1093/ageing/afae122] [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: 12/12/2023] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND Anxiety symptoms and disorders are common in older adults and often go undetected. A systematic review was completed to identify tools that can be used to detect anxiety symptoms and disorders in community-dwelling older adults. METHODS MEDLINE, Embase and PsycINFO were searched using the search concepts anxiety, older adults and diagnostic accuracy in March 2023. Included articles assessed anxiety in community-dwelling older adults using an index anxiety tool and a gold standard form of anxiety assessment and reported resulting diagnostic accuracy outcomes. Estimates of pooled diagnostic accuracy outcomes were completed. RESULTS Twenty-three anxiety tools were identified from the 32 included articles. Pooled diagnostic accuracy outcomes were estimated for the Geriatric Anxiety Inventory (GAI)-20 [n = 3, sensitivity = 0.89, 95% confidence interval (CI) = 0.70-0.97, specificity = 0.80, 95% CI = 0.67-0.89] to detect generalized anxiety disorder (GAD) and for the GAI-20 (n = 3, cut off ≥ 9, sensitivity = 0.74, 95% CI = 0.62-0.83, specificity = 0.96, 95% CI = 0.74-1.00), Beck Anxiety Inventory (n = 3, sensitivity = 0.70, 95% CI = 0.58-0.79, specificity = 0.60, 95% CI = 0.51-0.68) and Hospital Anxiety and Depression Scale (HADS-A) (n = 3, sensitivity = 0.78, 95% CI = 0.60-0.89, specificity = 0.76, 95% CI = 0.60-0.87) to detect anxiety disorders in clinical samples. CONCLUSION The GAI-20 was the most studied tool and had adequate sensitivity while maintaining acceptable specificity when identifying GAD and anxiety disorders. The GAI-20, GAI-Short Form and HADS-A tools are supported for use in detecting anxiety in community-dwelling older adults. Brief, self-rated and easy-to-use tools may be the best options for anxiety detection in community-dwelling older adults given resource limitations. Clinicians may consider factors including patient comorbidities and anxiety prevalence when selecting a tool and cut off.
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Affiliation(s)
- Kayla Atchison
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Pauline Wu
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Leyla Samii
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Michael Walsh
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Zahinoor Ismail
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada
- Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
| | - Andrea Iaboni
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zahra Goodarzi
- Department of Medicine, University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- O'Brien Institute for Public Health, University of Calgary, Calgary, Alberta, Canada
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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] [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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Jesus AG, de Lima MP, Vilar M, Pachana NA. Homebound elderly people psychotherapeutic intervention (HEPPI): Exploring the mediating role of loneliness. Arch Gerontol Geriatr 2024; 118:105308. [PMID: 38101250 DOI: 10.1016/j.archger.2023.105308] [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: 09/25/2023] [Revised: 11/22/2023] [Accepted: 12/01/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES The present study aimed to explore whether the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered ten-week cognitive-emotional intervention, was effective in reducing self-reported loneliness among homebound older adults presenting mild cognitive impairment and psychological symptomatology. Effects of HEPPI in total, social, and emotional loneliness, compared with a treatment-as-usual group, were investigated at post-intervention and 3-month follow-up. In addition, the potential role of social and emotional loneliness as mediators of the HEPPI impact on episodic memory and symptoms of depression and anxiety was examined. METHODS This study built upon the data of a previously conducted randomized controlled trial. Participants were randomly assigned to the HEPPI group (n = 98) or the treatment-as-usual group (n = 101) and completed baseline, post-intervention, and 3-month follow-up assessments, including measures of loneliness (UCLA - Loneliness scale), episodic memory (Wechsler Memory Scale-III), depressive symptoms (Geriatric Depression Scale-30), and anxiety symptoms (Geriatric Anxiety Inventory). Data were analyzed on an intention-to-treat basis employing linear mixed models and mediation analyses for repeated measures. CLINICALTRIALS gov identifier: NCT05499767. RESULTS Compared with usual care controls, the HEPPI participants reported a significant immediate decrease in total and social loneliness, but these effects were not maintained at a 3-month follow-up. The reduction in immediate perceived social loneliness significantly mediated the improvement of depressive symptoms. CONCLUSIONS The current findings suggest that HEPPI potentially reduced total and social loneliness of the homebound older population immediately post-intervention, and such decrease in social loneliness may be a relevant mechanism for improving their short-term depressive symptomatology.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal.
| | - Margarida Pedroso de Lima
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Rua do Colégio Novo, 3000-115, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Sir Fred Schonell Dr, St Lucia, QLD, 4072, Australia
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Jesus AG, Lima MPD, Vilar M, Pachana NA. HEPPI: a randomized controlled trial of the efficacy of a cognitive-emotional intervention for homebound older adults. Aging Ment Health 2024; 28:491-501. [PMID: 37747057 DOI: 10.1080/13607863.2023.2260760] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 09/11/2023] [Indexed: 09/26/2023]
Abstract
OBJECTIVES This randomized controlled trial aimed to assess the efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI), a home-delivered cognitive-emotional intervention, among the homebound older population presenting with mild cognitive impairment and depressive or anxiety symptoms. METHODS Participants were randomly assigned either to the intervention group or the treatment-as-usual group and completed baseline, post-intervention, and three-month follow-up assessments. Changes in episodic memory and symptoms of depression and anxiety were the primary outcomes. Secondary outcomes included changes in global cognition, attentional control, subjective memory complaints, functional status, and quality of life. Data were analyzed on an intention-to-treat basis employing a linear mixed models approach. ClinicalTrials.gov identifier: NCT05499767. RESULTS Compared with the treatment-as-usual group, the HEPPI group reported significant immediate improvement in cognition, mood, and daily functional performance. Positive effects of HEPPI were maintained over the follow-up phase only in depressive symptomatology, perceived incapacity to perform advanced instrumental activities of daily living, and self-reported emotional ability. A significant impact of the intervention on the subjective memory complaints level was observed only three months after the intervention. CONCLUSIONS This study suggests that HEPPI may be a promising home-delivered cognitive-emotional intervention to help homebound older adults improve their mental health.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Brisbane, Australia
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Russell SG, Quigley R, Thompson F, Sagigi B, Miller G, LoGiudice D, Smith K, Strivens E, Pachana NA. Culturally Appropriate Assessment of Depression and Anxiety in Older Torres Strait Islanders: Limitations and Recommendations. Clin Gerontol 2023; 46:240-252. [PMID: 35694996 DOI: 10.1080/07317115.2022.2086090] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The aim of the study was to assess the prevalence of anxiety and depression in older Aboriginal and Torres Strait Islander adults. METHODS A modified version of the PHQ-9 (KICA-dep) and the Geriatric Anxiety Inventory (GAI) were administered as part of a wider dementia prevalence study conducted in the Torres Strait. Results were compared to diagnoses obtained on Geriatric review to evaluate their applicability in the region. RESULTS A total of 236 participants completed the KICA-dep and 184 completed the GAI short form. Of these, 10.6% were identified with depression and 15.8% with anxiety. Some participants found questions about suicide ideation and self-harm offensive and others had difficulty understanding concepts on the GAI. The KICA-dep performed poorly in comparison to diagnosis on geriatric clinical review, so results are unlikely to reflect the true prevalence of depression in the region. CONCLUSIONS Further research is required to explore the underlying dimensions of depression and anxiety and terminology used to express mood symptoms in the Torres Strait. CLINICAL IMPLICATIONS • Current mental health screening tools are not applicable for the Torres Strait• More work is required to determine how symptoms of depression and anxiety are expressed within Torres Strait communities.
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Affiliation(s)
- Sarah G Russell
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Rachel Quigley
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Fintan Thompson
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Betty Sagigi
- Queensland Health, Torres and Cape Hospital and Health Service, Thursday Island, Australia
| | - Gavin Miller
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
| | - Dina LoGiudice
- Faculty of Medicine, Dentistry, and Health Services, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
| | - Kate Smith
- Centre for Aboriginal Medical and Dental Health, School of Medicine, University of Western Australia, Perth, Australia
| | - Edward Strivens
- College of Medicine and Dentistry, James Cook University, Cairns, Australia
- Queensland Health, Cairns and Hinterland Hospital and Health Service, Cairns, Australia
- Australian Institute of Tropical Health and Medicine, James Cook University, Cairns, Australia
| | - Nancy A Pachana
- School of Psychology, University of Queensland, Brisbane, Australia
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Silva-Fernandes A, Cruz S, Moreira CS, Pereira DR, Sousa SS, Sampaio A, Carvalho J. Processing speed mediates the association between physical activity and executive functioning in elderly adults. Front Psychol 2022; 13:958535. [PMID: 36092122 PMCID: PMC9462456 DOI: 10.3389/fpsyg.2022.958535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/04/2022] [Indexed: 11/27/2022] Open
Abstract
Advanced aging is associated with cognitive decline. To decrease the healthcare system and socio-economic burdens as well as to promote better quality of life, is important to uncover the factors that may be related to the delay of cognitive impairments in older adults. This study investigated the relationship between physical activity levels, sedentary behavior and cardiorespiratory fitness with cognitive functioning in healthy older adults. Furthermore, it examined the mediating role of processing speed on the association between physical activity and executive functions and long-term memory. Thirty-two individuals aged between 63 and 77 years (M = 68.16, SD = 3.73) underwent measurements of maximal oxygen uptake (VO2peak), 1-week of PA accelerometer measurement and a comprehensive cognitive assessment. Significant associations were observed between MVPA and cognitive processing speed. Equally, a significant positive indirect effect of MVPA on executive functioning and long-term memory was mediated by processing speed. Also, MVPA levels differentiated cognitive functioning in older adults – the physical active group outperformed the physical inactive group in processing speed, executive functions, and language abilities. Our results contribute to the literature on the MVPA levels as an important tool to promote healthier cognitive aging.
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Affiliation(s)
- Anabela Silva-Fernandes
- Psychological Neuroscience Laboratory, School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
- *Correspondence: Anabela Silva-Fernandes
| | - Sara Cruz
- The Psychology for Positive Development Research Center (CIPD), Lusíada University, Porto, Portugal
| | - Célia Sofia Moreira
- Department of Mathematics and Centre of Mathematics, University of Porto (FCUP & CMUP), Porto, Portugal
| | - Diana R. Pereira
- Psychological Neuroscience Laboratory, School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Sónia S. Sousa
- Psychological Neuroscience Laboratory, School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, School of Psychology, Psychology Research Center (CIPsi), University of Minho, Braga, Portugal
| | - Joana Carvalho
- Faculty of Sport, Research Center in Physical Activity, Health and Leisure (CIAFEL), University of Porto, Porto, Portugal
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Jesus AG, de Lima MP, Vilar M, Pachana NA. Feasibility, Acceptability, and Preliminary Efficacy of A Cognitive-Emotional Intervention Program in Homebound Older Adults: A Pilot Randomized Controlled Trial. Clin Gerontol 2022; 46:359-375. [PMID: 35916398 DOI: 10.1080/07317115.2022.2105670] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To conduct a pilot randomized controlled trial to assess the feasibility, acceptability, and preliminary efficacy of the Homebound Elderly People Psychotherapeutic Intervention (HEPPI) among homebound older adults with mild cognitive impairment and depressive or anxious symptomatology. METHODS Fifty-one participants were randomly assigned to the intervention group or to the wait-list control group and completed baseline and post-intervention assessments. Feasibility and acceptability were the primary outcomes. Secondary outcomes included changes in cognitive function, depressive and anxiety symptoms, subjective memory complaints, functional status, and quality of life. Intervention effects were assessed both at a group level (two-way mixed ANOVA) and at an individual level (Reliable Change Index). RESULTS The HEPPI was a feasible and acceptable non-pharmacological intervention. Compared to the wait-list control group, the intervention group showed significant improvement in cognitive, emotional, and functional domains at post-intervention. Differences between groups in the distributions by clinical change categories were observed. CONCLUSIONS Results provide evidence of the HEPPI's feasibility, acceptability, and preliminary efficacy in increasing the cognitive and functional performance of homebound older adults and reducing their psychological symptomatology. CLINICAL IMPLICATIONS Home-delivered cognitive-emotional interventions may be a promising and acceptable mental health approach for homebound older adults, improving their cognitive and emotional functioning.
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Affiliation(s)
- Andreia G Jesus
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | | | - Manuela Vilar
- Faculty of Psychology and Educational Sciences, University of Coimbra, Coimbra, Portugal
| | - Nancy A Pachana
- School of Psychology, The University of Queensland, Australia
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Teixeira-Santos AC, Moreira CS, Pereira DR, Pinal D, Fregni F, Leite J, Carvalho S, Sampaio A. Working Memory Training Coupled With Transcranial Direct Current Stimulation in Older Adults: A Randomized Controlled Experiment. Front Aging Neurosci 2022; 14:827188. [PMID: 35493937 PMCID: PMC9039392 DOI: 10.3389/fnagi.2022.827188] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/28/2022] [Indexed: 12/03/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) has been employed to boost working memory training (WMT) effects. Nevertheless, there is limited evidence on the efficacy of this combination in older adults. The present study is aimed to assess the delayed transfer effects of tDCS coupled with WMT in older adults in a 15-day follow-up. We explored if general cognitive ability, age, and educational level predicted the effects. Methods In this single-center, double-blind randomized sham-controlled experiment, 54 older adults were randomized into three groups: anodal-tDCS (atDCS)+WMT, sham-tDCS (stDCS)+WMT, and double-sham. Five sessions of tDCS (2 mA) were applied over the left dorsolateral prefrontal cortex (DLPFC). Far transfer was measured by Raven’s Advanced Progressive Matrices (RAPM), while the near transfer effects were assessed through Digit Span. A frequentist linear mixed model (LMM) was complemented by a Bayesian approach in data analysis. Results Working memory training improved dual n-back performance in both groups submitted to this intervention but only the group that received atDCS+WMT displayed a significant improvement from pretest to follow-up in transfer measures of reasoning (RAPM) and short-term memory (forward Digit Span). Near transfer improvements predicted gains in far transfer, demonstrating that the far transfer is due to an improvement in the trained construct of working memory. Age, formal education, and vocabulary score seem to predict the gains in reasoning. However, Bayesian results do not provide substantial evidence to support this claim. Conclusion This study will help to consolidate the incipient but auspicious field of cognitive training coupled with tDCS in healthy older adults. Our findings demonstrated that atDCS may potentialize WMT by promoting transfer effects in short-term memory and reasoning in older adults, which are observed especially at follow-up.
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Affiliation(s)
- Ana C. Teixeira-Santos
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Department of Social Sciences, Institute for Research on Socio-Economic Inequality, University of Luxembourg, Esch-Belval, Luxembourg
- *Correspondence: Ana C. Teixeira-Santos,
| | - Célia S. Moreira
- Department of Mathematics, Centre for Mathematics of the University of Porto, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Diana R. Pereira
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Diego Pinal
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
| | - Felipe Fregni
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
| | - Jorge Leite
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Spaulding Neuromodulation Center, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States
- Portucalense Institute for Human Development, Universidade Portucalense, Porto, Portugal
| | - Sandra Carvalho
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Translational Neuropsychology Lab, Department of Education and Psychology and William James Center for Research (WJCR), University of Aveiro, Campus Universitário de Santiago, Aveiro, Portugal
| | - Adriana Sampaio
- Psychological Neuroscience Laboratory, Psychology Research Centre, School of Psychology, University of Minho, Braga, Portugal
- Adriana Sampaio,
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Justo-Henriques SI, Pérez-Sáez E, Apóstolo JLA, Carvalho JO. Effectiveness of a Randomized Controlled Trial of Individual Reminiscence Therapy on Cognition, Mood and Quality of Life in Azorean Older Adults with Neurocognitive Disorders. J Clin Med 2021; 10:5395. [PMID: 34830677 PMCID: PMC8619984 DOI: 10.3390/jcm10225395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/14/2021] [Accepted: 11/17/2021] [Indexed: 12/02/2022] Open
Abstract
Reminiscence therapy (RT) is a form of cognitive stimulation therapy that incorporates discussion of past activities, events, and experiences to stimulate individual memories; it has had some success in treating persons with neurocognitive disorders. This research aims to evaluate the ability of individual RT, using a simple reminiscence format, to improve the overall cognitive function, memory, executive functions, emotional status, and quality of life in older adults with neurocognitive disorders who received social care and support services. A multicenter randomized controlled trial was completed in the Azores archipelago (an independent region of Portugal) using repeated measures (pre-intervention, post-intervention, and follow-up). The intervention group underwent individual RT sessions, twice weekly for 13 weeks, while the control group completed regular activities administered as part of their program. Results did not reveal any significant differences between the intervention and control groups. While results did not reveal significant effects, a number of historical and contextual factors are considered as possible explanations for the lack of effects-namely, data collection occurring during the COVID-19 global pandemic, participant cohort effects, and therapist heterogeneity.
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Affiliation(s)
- Susana I Justo-Henriques
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Enrique Pérez-Sáez
- National Reference Centre for Alzheimer's and Dementia Care, Imserso, 37008 Salamanca, Spain
| | - João L Alves Apóstolo
- Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra (ESEnfC), 3004-011 Coimbra, Portugal
| | - Janessa O Carvalho
- Psychology Department, Bridgewater State University, Bridgewater, MA 02325, USA
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Effects of restraining measures due to COVID-19: Pre- and post-lockdown cognitive status and mental health. CURRENT PSYCHOLOGY 2021; 41:7383-7392. [PMID: 33897227 PMCID: PMC8057859 DOI: 10.1007/s12144-021-01747-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 12/21/2022]
Abstract
The COVID-19 pandemic has prompted all countries to adopt restraining measures to mitigate the spread of the disease. Usually, large-scale disasters tend to be accompanied by significant increases of psychological distress, depression and anxiety. Confinement measures imposed during the COVID-19 pandemic are likely to have similar consequences. In the present study we aim to evaluate how COVID-19 affected the overall psychological functioning of Portuguese individuals by providing a comparison of current data with status prior to the COVID-19 pandemic. The study sample was composed of 150 cognitively healthy participants. Results show an overall maintenance of cognitive capacities, although subjective cognitive decline complaints significantly increased during the pandemic. Regarding mental health, restraining measures culminated in an aggravation of depressive and decrease of the perceived quality of life, associated with feelings of loneliness and perceived social isolation. Finally, higher levels of pre-COVID-19 quality of life seem to play a protective role against depression and anxiety and predict less difficulties in emotion regulation, feelings of solitude and cognitive complaints. In sum, confinement due to COVID-19 implied an aggravation of the mental health of the Portuguese population, which appears to have been attenuated in those with higher pre-pandemic levels of perceived quality of life.
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Shati M, Mortazavi SS, Taban M, Malakouti SK, Mehravaran S, Norouzi A, Pachana NA. Psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form. Med J Islam Repub Iran 2021; 35:47. [PMID: 34268235 PMCID: PMC8271228 DOI: 10.47176/mjiri.35.47] [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: 02/24/2020] [Indexed: 11/09/2022] Open
Abstract
Background: Despite studies about anxiety in the older adult, the prevalence of anxiety in this age group is not exactly clear, which may be due to the use of tools and criteria that were not born for this age group. One of the instruments designed to assess anxiety in the elderly is the Geriatric Anxiety Inventory (GAI). The aim of this research was to analyze the psychometric properties of the Persian version of the Geriatric Anxiety Inventory (GAI-PV) and its short form (GAI-PV-SF) in a sample of older adults in Iran. Methods: In this cross-sectional study, a sample of 150 community-dwelling and a psychogeriatric sample of 48 adults older than 60 years completed the GAI-PV and GAI-PV-SF, the anxiety sub-scale of the General Health Questionnaire (GHQ-28), the Geriatric Depression Scale (GDS-15), and the Structured Clinical Interview for DSM-IV (SCID-I). Different types of validity and reliability were evaluated for GAI-PV and GAI-PV-SF using SPSS and the LISREL software. Results: Both the GAI-PV and GAI-PV-SF exhibited excellent internal consistency (over 80 %) and desirable concurrent validity against GHQ-28 and GDS-15. The optimal cutpoint score to detect current generalized anxiety disorder (GAD) was 10/11 and 13/14 for GAI-PV in the community-dwelling and psychogeriatric samples, respectively, and 3/4 for GAI-PV-SF in both study samples. Good test-retest reliability (correlation coefficient: 0.96 and 0.88 for GAI-PV and GAI-PV-SF, respectively) and a single-factor structure were also demonstrated. Conclusion: Sound psychometric properties of the GAI-PV in both subsamples suggest that the instrument could be used successfully as an accurate screening instrument in the elderly Iranian population.
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Affiliation(s)
- Mohsen Shati
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Seyede Salehe Mortazavi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry) Iran University of Medical Sciences, Tehran, Iran
- Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mozhgan Taban
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Kazem Malakouti
- Mental Health Research Center, Psychosocial Health Research Institue, Iran University of Medical Sciences, Tehran, Iran
| | - Shiva Mehravaran
- ASCEND Center for Biomedical Research, Morgan State University, Baltimore, MD, USA
| | - Ali Norouzi
- Medical Education Department, Medical School, Tehran University of Medical Sciences, Tehran, Iran
- Education Development Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Nancy A. Pachana
- School of Psychology, University of Queensland, Brisbane, 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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Calamia M, Weitzner DS, De Vito AN, Bernstein JPK, Allen R, Keller JN. Feasibility and validation of a web-based platform for the self-administered patient collection of demographics, health status, anxiety, depression, and cognition in community dwelling elderly. PLoS One 2021; 16:e0244962. [PMID: 33465108 PMCID: PMC7815113 DOI: 10.1371/journal.pone.0244962] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 12/19/2020] [Indexed: 12/26/2022] Open
Abstract
The coronavirus disease pandemic has brought a new urgency for the development and deployment of web-based applications which complement, and offer alternatives to, traditional one-on-one consultations and pencil-and-paper (PaP) based assessments that currently dominate clinical research. We have recently developed a web-based application that can be used for the self-administered collection of patient demographics, self-rated health, depression and anxiety, and cognition as part of a single platform. In this study we report the findings from a study with 155 cognitively healthy older adults who received established PaP versions, as well as our novel computerized measures of self-rated health, depression and anxiety, and cognition. Moderate to high correlations were observed between PaP and web- based measures of self-rated health (r = 0.77), depression and anxiety (r = 0.72), and preclinical Alzheimer’s disease cognitive composite (PACC) (r = .61). Test-retest correlations were variable with high correlations for a measure of processing speed and a measure of delayed episodic memory. Taken together, these data support the feasibility and validity of utilization of this novel web-based platform as a new alternative for collecting patient demographics and the assessment of self-rated health, depression and anxiety, and cognition in the elderly.
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Affiliation(s)
- Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, United States of America
- * E-mail:
| | - Daniel S. Weitzner
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Alyssa N. De Vito
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - John P. K. Bernstein
- Department of Psychology, Louisiana State University, Baton Rouge, Louisiana, United States of America
| | - Ray Allen
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
| | - Jeffrey N. Keller
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, United States of America
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Pachana NA, Byrne GJ. The Geriatric Anxiety Inventory: International Use and Future Directions. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2011.00052.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Weitzner D, Calamia M, Stasik-O'Brien SM, De Vito A, Pugh E. Psychometric properties of the expanded version of the inventory of depression and anxiety symptoms (IDAS-II) in a sample of older adults. Aging Ment Health 2020; 24:1847-1853. [PMID: 31264444 DOI: 10.1080/13607863.2019.1636206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Given the strong relationship often found between self-report measures of anxiety and depression, the Inventory of Depression and Anxiety Symptoms (IDAS) was created and then expanded (IDAS-II) to assess common and unique symptom dimensions of these emotional disorders. Limited research has focused on the use of the IDAS-II with older adults and the purpose of the current study was to provide data on the reliability and validity of the IDAS-II in this population.Method: A sample of 323 participants (age 55-80 years) were recruited online using Amazon's Mechanical Turk (MTurk). They completed the IDAS-II and several other self-report questionnaires of internalizing symptoms, including widely used measures developed specifically for older adults. Internal consistency and validity of the IDAS-II were examined.Results: The IDAS-II demonstrated marginal to excellent internal consistency (α = .68-.91). An exploratory factor analysis indicated three factors: Distress, Positive Mood, and Obsessions. The IDAS-II explained a large amount of variance in the other measures of depression and anxiety (ranging from 52% to 76%) and the IDAS-II Dysphoria scale significantly related to all of the other measures of depression and anxiety (ranging from r = .69 to r = .81).Conclusion: These results support the use of the IDAS-II with older adults as it has good convergent validity with other commonly used measures of depression and anxiety, including those commonly used in the assessment of older adults. Further research can use the IDAS-II with both younger and older adults to examine age-related changes in depression and anxiety symptoms.
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Affiliation(s)
- Daniel Weitzner
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Matthew Calamia
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | | | - Alyssa De Vito
- Psychology Department, Louisiana State University, Baton Rouge, LA, USA
| | - Erika Pugh
- Psychology Department, Louisiana State University, Baton Rouge, LA, 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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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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The prevalence and predictors of anxiety and depression in near-centenarians and centenarians: a systematic review. Int Psychogeriatr 2019; 31:1539-1558. [PMID: 31354113 DOI: 10.1017/s1041610219000802] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Current research on the psychological health of near-centenarians (95-99 years old) and centenarians remains limited. Existing studies have mainly characterized their physical, cognitive, and social health. Results on the anxiety and depression of near-centenarians and centenarians (more than 95 years old) have been mixed with some studies, finding higher rates of anxiety and depression among those older than 95 years and others reporting no difference in rates compared with younger age groups. This study aims to synthesize the existing literature on the prevalence and predictors of anxiety and depression in near-centenarians and centenarians. METHOD A systematic review was conducted using Ovid Medline, Embase, PsycINFO, CINAHL, SCOPUS, and the Cochrane database. Common and conflicting findings among the literature were examined. RESULTS Thirty-eight studies met the inclusion criteria. Six studies examined the prevalence and predictors of anxiety, and 37 studies investigated the prevalence and predictors of depression. Five studies examined both anxiety and depression in the same sample. Prevalence data on anxiety and depression varied significantly, as did comparisons with rates in younger populations. Findings on predictors of anxiety and depression were contradictory. CONCLUSION There is a large degree of heterogeneity among studies of centenarians' psychological status. Findings conflict on the prevalence and predictors of anxiety and depression and rates compared with younger age groups. Variation in findings may result from the different inclusion criteria, sampling methods, and measurement tools. Better harmonization of centenarian study methodologies may improve consistency of findings to aid in developing clinical interventions.
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Ribeiro O, Brandão D, Oliveira AF, Martín I, Teixeira L, Paúl C. The Modified Caregiver Strain Index: Portuguese version. J Health Psychol 2019; 26:1597-1608. [DOI: 10.1177/1359105319883933] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The Modified Caregiver Strain Index is a widely used tool to screen for caregiver strain in family caregivers. This study presents the Portuguese version of the Modified Caregiver Strain Index and explores its psychometric properties in a sample of 347 informal caregivers of older dependent individuals. Factor analysis revealed a two-factor structure and indicated satisfactory internal consistency. Criterion-related validity was supported by positive significant correlations with the emotional health of the caregiver (psychological distress). The findings show evidence of reliability and validity of the Portuguese version of the Modified Caregiver Strain Index encouraging its use in clinical and research fields.
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Affiliation(s)
- Oscar Ribeiro
- Department of Education and Psychology, University of Aveiro (DEP-UA), Portugal
- Center for Health Technology and Services Research (CINTESIS), Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Portugal
| | - Daniela Brandão
- Center for Health Technology and Services Research (CINTESIS), Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Portugal
| | - Ana Filipa Oliveira
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Portugal
| | - Ignacio Martín
- Department of Education and Psychology, University of Aveiro (DEP-UA), Portugal
- Center for Health Technology and Services Research (CINTESIS), Portugal
| | - Laetitia Teixeira
- Center for Health Technology and Services Research (CINTESIS), Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Portugal
- Public Health Institute, University of Porto (ISPUP), Portugal
| | - Constança Paúl
- Center for Health Technology and Services Research (CINTESIS), Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto (ICBAS-UP), Portugal
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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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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: 142] [Impact Index Per Article: 23.7] [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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Sousa M, Pereira A, Costa R, Gomes P. As queixas subjetivas de memória num cuidado de saúde primário: Um estudo follow up. PSYCHOLOGY, COMMUNITY & HEALTH 2017. [DOI: 10.5964/pch.v6i1.204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objetivo As queixas subjetivas de memória (QSM) são um fator clínico relevante e uma das principais queixas feitas aos médicos de família por adultos e adultos idosos. Este estudo, realizado numa Unidade de Saúde Familiar da Região Centro de Portugal, teve como objetivo caracterizar as QSM em função de variáveis sociodemográficas, clínicas, cognitivas, emocionais e de qualidade de vida. Método Este estudo, de coorte prospetivo em dois momentos, procurou explorar a evolução das QSM durante 18 meses e quais os fatores que se associam. Foi levado a cabo numa amostra de 19 adultos e de adultos idosos com idades compreendidas entre os 55 e os 81 anos (79.2% do sexo feminino). Os dados foram recolhidos por entrevistas semiestruturadas e sempre que possível foram consultados os processos clínicos. Foram utilizados como instrumentos de medida o Mini Mental State Examination (MMSE), o Montreal Cognitive Assessment (MoCA), a Escala de Queixas de Memória (EQM), a Escala de Depressão Geriátrica (GDS), o Inventário de Ansiedade Geriátrica (GAI), a Avaliação de Qualidade de Vida da Organização Mundial de Saúde (WHOQOL-Bref) e por um questionário sociodemográfico e clínico construído para o efeito. Resultados No segundo momento avaliativo, todos os participantes evidenciam QSM, sendo estas influenciadas significativamente pela idade. Houve ainda um aumento da sintomatologia depressiva e ansiógena, dos valores da Hemoglobina glicosilada (HbA1c) e do número de medicamentos consumidos, com particular ênfase nos anti hipertensores. Conclusão As QSM deverão ser objeto de preocupação e vigilância do médico de família, uma vez que podem representar um sintoma relevante para a identificação precoce de um processo demencial.
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Abstract
OBJECTIVES Our aims were to explore prevalence of anxiety among patients admitted to departments of geriatric psychiatry for treatment of various diagnoses and to examine how often anxiety was registered as a previous or ongoing diagnosis. METHOD In all, 473 patients admitted to one of five departments of geriatric psychiatry were included in a quality register and examined according to a standardized protocol. The Geriatric Anxiety Inventory (GAI) was used to measure anxiety during the first week after admission. Diagnoses were made at discharge. RESULTS Using a cutoff on the GAI of 8/9, the prevalence of anxiety for the following diagnostic groups was depression 65.3%, psychosis 28%, dementia 38.8% and mania 33.3%. Of 24 patients with a primary diagnosis of anxiety, 66.7% scored above 8 on the GAI. Of 236 patients with a GAI score above 8, only 22 (9.3%) were reported to have a comorbid anxiety disorder by the treating psychiatrist. In a multiple regression analysis, we found that the severity of depression (beta 0.585, p < 0.001), being female (beta 0.096, p 0.028) and the use of antipsychotic drugs (beta 0.129, p 0.006) and anxiolytic drugs (beta 0.129, p 0.005) were associated with a higher GAI score. CONCLUSION Anxiety is common in geriatric psychiatric patients, regardless of the primary diagnosis. Our findings suggest that anxiety is often a hidden comorbidity in various psychiatric disorders. A high score on the GAI was associated with the severity of depression, female gender and the use of antipsychotic and anxiolytic drugs.
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Affiliation(s)
- Anette Bakkane Bendixen
- a Department of Geriatric Psychiatry , Diakonhjemmet Hospital, University of Oslo , Oslo , Norway
| | - Knut Engedal
- b Norwegian Advisory Unit of Aging and Health , Vestfold Hospital Trust, Toensberg, University of Oslo , Oslo , Norway
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A quasi-experimental study of a reminiscence program focused on autobiographical memory in institutionalized older adults with cognitive impairment. Arch Gerontol Geriatr 2016; 66:183-92. [PMID: 27347792 DOI: 10.1016/j.archger.2016.05.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Revised: 05/12/2016] [Accepted: 05/13/2016] [Indexed: 11/23/2022]
Abstract
Working with past memories through reminiscence interventions has been practiced for several decades with successful outcomes on mental health in older adults. Few studies however have focused on autobiographical memory recall in older individuals with cognitive impairment. This study aims to analyze the impact of an individual reminiscence program in a group of older persons with cognitive decline living in nursing homes on the dimensions of cognition, autobiographical memory, mood, behavior and anxiety. A two-group pre-test and post-test design with single blinded assessment was conducted. Forty-one participants were randomized to an experimental group (n=20) and a control group (n=21). The first group attended five weekly individual reminiscence sessions. Changes in the outcome measures were examined for cognition (Montreal Cognitive Assessment; Autobiographical Memory Test), behavior (Alzheimer Disease Assessment Subscale Non-Cog) and emotional status (Cornell Scale for Depression in Dementia; Geriatric Depression Scale, and Geriatric Anxiety Inventory). Participants attending reminiscence sessions exhibited better outcomes compared to the control group in cognition, anxiety and depression (p<0.001), and presented a higher number of retrieved autobiographical events, specificity of evoked memories and positive valence of events (p<0.001), and also presented lower latency time for recalling events, and lower negative recalled events (p<0.01). This study supports the potential value of reminiscence therapy in improving the recall of autobiographical memory. Reminiscence therapy can be helpful to maintain or improve cognitive function, decrease anxiety and manage depressive symptoms and altered behavior, but further investigation is needed to clarify long-term effects.
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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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Development and preliminary evaluation of the anxiety in cognitive impairment and dementia (ACID) scales. Int Psychogeriatr 2015; 27:1825-38. [PMID: 26176688 DOI: 10.1017/s1041610215001027] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although rates of anxiety tend to decrease across late life, rates of anxiety increase among a subset of older adults, those with mild cognitive impairment (MCI) or dementia. Our understanding of anxiety in dementia is limited, in part, by a lack of anxiety measures designed for use with this population. This study sought to address limitations of the literature by developing a new measure of anxiety for cognitively impaired individuals, the anxiety in cognitive impairment and dementia (ACID) Scales, which includes both proxy (ACID-PR) and self-report (ACID-SR) versions. METHODS The ACID-SR and ACID-PR were administered to 45 residents, aged 60 years and older, of three long-term care (LTC) facilities, and 38 professional caregivers at these facilities. Other measures of anxiety, and measures of depression, functional ability, cognition, and general physical and mental health were also administered. RESULTS Initial evaluation of its psychometric properties revealed adequate to good internal consistency for the ACID-PR and ACID-SR. Evidence for convergent validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by moderate-to-strong associations with measures of worry, depressive symptoms, and general mental health. Discriminant validity of measures obtained with the ACID-SR and ACID-PR was demonstrated by weak correlations with measures of cognition, functional ability, and general physical well-being. CONCLUSIONS The preliminary results suggest that the ACID-SR and ACID-PR can obtain reliable and valid measures of anxiety among individuals with cognitive impairment. Given the subjective nature of anxiety, it may be prudent to collect self-report of anxiety symptoms even among those with moderate cognitive impairment.
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Abstract
BACKGROUND The Geriatric Anxiety Inventory (GAI) is a recently developed scale aiming to evaluate symptoms of anxiety in later life. This 20-item scale uses dichotomous answers highlighting non-somatic anxiety complaints of elderly people. The present study aimed to evaluate the psychometric properties of the Brazilian Portuguese version GAI (GAI-BR) in a sample from community and outpatient psychogeriatric clinic. METHODS A mixed convenience sample of 72 subjects was recruited for answering the research protocol. The interview procedures were structured with questionnaires about sociodemographic data, clinical health status, anxiety, and depression previously validated instruments, Mini-Mental State Examination, Mini International Neuropsychiatric Interview, and GAI-BR. Twenty-two percent of the sample were interviewed twice for test-retest reliability. For internal consistency analyses, the Cronbach's α test was applied. The Spearman correlation test was applied to evaluate the test-retest GAI-BR reliability. A ROC (receiver operating characteristic) curve study was made to estimate the GAI-BR area under curve, cut-off points, sensitivity, and specificity for the Generalized Anxiety Disorder diagnosis. RESULTS The GAI-BR version showed high internal consistency (Cronbach's α = 0.91) and strong and significant test-retest reliability (ρ = 0.85, p < 0.001). It also showed moderate and significant correlation with the Beck Anxiety Inventory (ρ = 0.68, p < 0.001) and the State-Trait Anxiety Inventory (ρ = 0.61, p < 0.001) showing evidence of concurrent validation. The cut-off point of 13 estimated by ROC curve analyses showed sensitivity of 83.3% and specificity of 84.6% to detect Generalized Anxiety Disorder (DSM-IV). CONCLUSION GAI-BR has demonstrated very good psychometric properties and can be a reliable instrument to measure anxiety in Brazilian elderly people.
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Abstract
BACKGROUND Centenarians' psychological well-being is presently of great interest in psychogeriatric research but little is known about factors that specifically account for the presence of clinically relevant anxiety symptoms in this age group. This study examined the presence of anxiety and its predictors in a sample of centenarians and aims to contribute to a better understanding of anxiety determinants in extreme old age. METHODS We examined how socio-demographic, health, functional, and social factors contribute to the presence of clinically significant anxiety symptoms in centenarians recruited from two Portuguese centenarian studies. The Geriatric Anxiety Inventory - Short Form (GAI-SF) was used to assess anxiety symptoms. RESULTS A total of 97 centenarians (mean age 101.1 years; SD = 1.5 years; range = 100-108) with no/minor cognitive impairment were included. Clinically significant anxiety symptoms (GAI-SF ≥3) were present in 45.4% (n = 44) of the sample. Main predictive factors included worse health perception, higher number of medical conditions, financial concerns related to medical expenses (income inadequacy) and loneliness. CONCLUSIONS Results suggest that along with health status (subjective and objective), income inadequacy related to medical expenses and feeling lonely may predispose centenarians to clinically significant anxiety and be important to their overall well-being. Further research is needed on the repercussions of clinical anxiety in centenarians' quality of life and on co-morbid conditions (e.g. depression) at such advanced ages.
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Sousa M, Pereira A, Costa R, Rami L. Initial phase of adaptation of Memory Alteration Test (M@T) in a Portuguese sample. Arch Gerontol Geriatr 2015; 61:103-8. [DOI: 10.1016/j.archger.2015.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 11/29/2022]
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Coelho T, Santos R, Paúl C, Gobbens RJJ, Fernandes L. Portuguese version of the Tilburg Frailty Indicator: Transcultural adaptation and psychometric validation. Geriatr Gerontol Int 2014; 15:951-60. [PMID: 25255891 DOI: 10.1111/ggi.12373] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2014] [Indexed: 01/14/2023]
Abstract
AIM To present the translation and validation process of the Portuguese version of the Tilburg Frailty Indicator (TFI). METHODS A cross-sectional study was designed using a non-probability sample of 252 community-dwelling older adults. Preliminary studies were carried out for face and content validity assessment. Internal consistency, test-retest reliability, construct (convergent/divergent) and criterion validity were subsequently analyzed. RESULTS The sample was mainly women (75.8%), with a mean age of 79.2 ± 7.3 years. TFI internal consistency was good (KR-20 = 0.78). Test-retest reliability for the total was also good (r = 0.91), with kappa coefficients showing substantial agreement for most items. TFI physical and social domains correlated as expected with concurrent measures, whereas the TFI psychological domain showed similar correlations with other psychological and physical measures. The TFI showed a good to excellent discrimination ability in regard to frailty criteria, and fair to good ability to predict adverse outcomes. CONCLUSIONS The psychometric properties of the TFI seem to be consistently good. These findings provide initial evidence that the Portuguese version is a valid and reliable measure for assessing frailty in the elderly.
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Affiliation(s)
- Tiago Coelho
- School of Allied Health Sciences, Porto Polytechnic Institute, Vila Nova de Gaia, Portugal.,UNIFAI/ICBAS, University of Porto, Porto, Portugal
| | - Rubim Santos
- Activity and Human Movement Study Center, School of Allied Health Sciences, Porto Polytechnic Institute, Vila Nova de Gaia, Portugal
| | | | - Robbert J J Gobbens
- Research & Development Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, the Netherlands
| | - Lia Fernandes
- UNIFAI/CINTESIS - Faculty of Medicine, University of Porto, Porto, Portugal
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Application of the Geriatric Anxiety Inventory-Chinese Version (GAI-CV) to older people in Beijing communities. Int Psychogeriatr 2014; 26:517-23. [PMID: 24252312 DOI: 10.1017/s1041610213002007] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND The Geriatric Anxiety Inventory (GAI) was developed to assess anxiety in older adults. The objectives of this work were as follows: (a) to analyze the psychometric properties of the Chinese version of the GAI (GAI-CV), and (b) to explore the extent of anxiety and related factors in the elderly Chinese residents of Beijing. METHODS Participants in this study included 1,047 people (59.4% female) more than 60 years old who were living in the community. They were randomly selected from 15 communities in Beijing. Basic information was collected. Anxiety was measured using the GAI-CV, the Self-Rating Anxiety Scale (SAS), and the Beck Anxiety Inventory (BAI). RESULTS The GAI-CV exhibited good internal consistency (Cronbach's α = 0.94) and demonstrated good concurrent validity against the SAS (r = 0.52, p = 0.018) and the BAI (r = 0.560, p = 0.000). Item response theory (IRT) analyses showed that the items of the GAI-CV exhibited high difficulty (0.97-2) and discrimination parameters (1.91-5.33). The items exhibited information parameters greater than 1.25 with the exceptions of items 2, 12, and 18. The GAI-CV scores were significantly associated with gender, age, and chronic disease. However, no significant differences due to marriage or education were found. CONCLUSIONS The GAI is a new scale that was specifically designed to measure anxiety in older people. The results of this study suggest that the GAI-CV had good psychometric properties, but some items need to be modified. IRT analyses indicated that the GAI-CV provided good measures of anxiety across the moderately high to very high levels. The GAI-CV may be a useful instrument for further research studies aimed at analyzing high-level anxiety among older adults in China.
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