Gai Geriatric Anxiety Inventory Pdf

[Ellyn Krucke]

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Background: Anxiety symptoms and anxiety disorders are highly prevalent among elderly people, although infrequently the subject of systematic research in this age group. One important limitation is the lack of a widely accepted instrument to measure dimensional anxiety in both normal old people and old people with mental health problems seen in various settings. Accordingly, we developed and tested of a short scale to measure anxiety in older people.

Methods: We generated a large number of potential items de novo and by reference to existing anxiety scales, and then reduced the number of items to 60 through consultation with a reference group consisting of psychologists, psychiatrists and normal elderly people. We then tested the psychometric properties of these 60 items in 452 normal old people and 46 patients attending a psychogeriatric service. We were able to reduce the number of items to 20. We chose a 1-week perspective and a dichotomous response scale.

Results: Cronbach's alpha for the 20-item Geriatric Anxiety Inventory (GAI) was 0.91 among normal elderly people and 0.93 in the psychogeriatric sample. Concurrent validity with a variety of other measures was demonstrated in both the normal sample and the psychogeriatric sample. Inter-rater and test-retest reliability were found to be excellent. Receiver operating characteristic analysis indicated a cut-point of 10/11 for the detection of DSM-IV Generalized Anxiety Disorder (GAD) in the psychogeriatric sample, with 83% of patients correctly classified with a specificity of 84% and a sensitivity of 75%.

Conclusions: The GAI is a new 20-item self-report or nurse-administered scale that measures dimensional anxiety in elderly people. It has sound psychometric properties. Initial clinical testing indicates that it is able to discriminate between those with and without any anxiety disorder and between those with and without DSM-IV GAD.

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.

Untreated anxiety can lead to cognitive impairment, disability, poor physical health, and a poor quality of life. But dementia can also be present in individuals in this age group, which means mood disorders such as anxiety and depression can be overlooked, as symptoms such as memory impairment and changes in everyday activities are similar.

Developed by researchers at The University of Queensland in Brisbane, Australia, the Geriatric Anxiety Inventory (GAI) is a simple tool that enables screening in older adults who may have undetected anxiety. The GAI can help point the way to a proper diagnostic workup and timely intervention. Topics covered include feelings of fearfulness, worry, physical symptoms of anxiety, and concerns about the impacts of worry and anxiety.

The GAI is used by health care services, nursing homes, geriatric facilities, pharmaceutical companies, geriatricians, psychologists, academics, and older people and their families, all around the world.

"The GAI is easy to administer which makes it perfect for assessing older adults living in residential aged care with physical and cognitive limitations. It is very reassuring to know that we have a well-validated tool that is so well suited to use for our clients in this setting."

"I find both questionnaires very user friendly. They are easy to understand. The scores are also easy to explain to clients.

They make a great pro and post intervention outcome measure. I think it a therapeutic intervention when I come back months later and show the scores have improved. People are often pleasantly surprised!"

The Research Licence is ideal for use by individual students, academic or teaching institutions. Where the teaching institution is also a clinical service provider, then a General Use Licence is required. Research Licencees are not permitted to use the GAI for clinical intervention/treatment.

The GAI team recognise and pay respect to Aboriginal and Torres Strait Islander peoples, their ancestors and the Elders past, present and future from the different First Nations across Australia. We acknowledge the importance of connection to land, culture, spirituality, ancestry, family and community for the wellbeing of all Aboriginal and Torres Strait Islander people.

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.

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.

As the geriatric population increases, mental health of the elderly gains more and more substantial concerns, such as depression and anxiety. Prevalence estimates of anxiety disorders ranged from 3.2 to 14.2% in Switzerland and France, as reported in a comprehensive review of geriatric anxiety disorders [1]. Moreover, a survey in one city in China, Chongqing, indicated that 21.63% of older people suffered anxiety, especially among those with physical illness [2]. Though anxiety disorders are highly prevalent among older adults, screening instruments for the aged leave much to be desired [3]. Besides confusion with other disorders [4], cognitive deficits and somatic symptoms account together for the unsatisfactory validity of most measures [5, 6]. To overcome the above deficiencies, Pachana et al. developed the Geriatric Anxiety Inventory (GAI), especially for older populations [3].

Factor structure is essential in understanding, scoring, and interpreting the responses on the GAI [11]. The GAI was developed as a measure of a unidimensional construct [3, 12]. However, researchers have not reached a consensus on the factor structure of this instrument. The one-factor model was confirmed by Johnco et al. among 256 community-dwelling old adults in Australia [13], among older people living in Beijing communities [14] and among institutionalized old population in Portugal using both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) [15]. The unidimensionality was further supported by Molde et al. among psychogeriatric mixed in-and-out Norwegian patients using the bifactor analysis [11]. Although the one-factor model obtained most empirical support, two-, three-, and four-factor solutions also emerged in the current literature. A two-factor model was proposed by Ribeiro et al. based on the principal component analysis with varimax rotation on responses from a mixed sample of community-dwelling and clinical old adults [16]. Bendixen et al. found a similar two-factor solution among a sample of elderly with depression, dementia, or psychosis [17]. A three-factor model was first proposed by Mrquez-Gonzlez et al. among 302 old adults living in Spanish communities using principal-components analysis with varimax rotation [18]. Guan also obtained a similar three-factor among 1318 old adults living in Beijing communities with the same method [19]. Finally, a four-factor model was proposed by Diefenbach et al. among a mixed sample of 140 clinical and non-clinical old participants using principal components analysis [20]. These inconsistent findings regarding dimensionality of the GAI can be partly attributed to the analytic methods chosen: Traditional factorial analysis methods such as exploratory factor analysis (EFA) and principal components analysis (PCA) are mainly employed in those studies, and these methods may result in distorted results due to small size and unsatisfied assumptions [21, 22]. More recently, Molde et al. [23] resolved debates about the factor structure of the GAI with bifactor modeling in an extensive dataset with 3731 older adults from 10 national samples and found a primary unidimensional general factor of the GAI across nations.

Therefore, the present study had two aims: 1) to establish the factor structure of the GAI in a large Chinese sample using Mokken scale analysis [24, 25]; 2) to examine the measurement invariance of the instrument across different groups using DIF analysis.

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