Standard Tools Validly Assess Depression, Anxiety in Home-Dwelling Seniors

Elderly woman with a headache.
Elderly woman with a headache.
Researchers investigated the validity of the Norwegian versions of the GDS-5 and HADS-D assessment tools among home-dwelling individuals aged 60 years or older.

The Geriatric Depression Scale-5 (GDS-5) and Hospital Anxiety Depression Scale-D (HADS-D) are useful screening tools for old home-dwelling adults, but perform only fairly well in identifying depression compared with the International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), according to research published in the Journal of Affective Disorders.

The sample included 194 home-dwelling adults with and without depressive symptoms. The participants were then assessed for depressive symptoms using the GDS-5 and HADS-5, and additionally examined for cognitive impairment. Researchers also collected sociodemographic information. Participants then underwent a blinded diagnostic evaluation of depressive episodes according to the ICD-10 diagnostic criteria.

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Out of the cohort, 56 participants (28.9%) satisfied the ICD-10 criteria for a depressive episode. The receiver operating characteristics analyses of HAD-D and GDS-5 showed that the cutoff points of the measures that produced the highest accuracies were ≥4 for HAD-D, with a sensitivity of 70.3% and a specificity of 69.6%, and ≥2 for GDS-5, with a sensitivity of 73.2% and a specificity of 73.2%. Using these cutoff points “should thus lead to further diagnostic examination of depressive symptoms,” according to the researchers.

The study was limited by its small sample size and reliance on guided self-reporting questionnaires. In addition, the study did not separate adults with and without home healthcare.

“GDS-5 and HADS-D are useful screening tools for old home-dwelling adults, but only fairly good to identify depression according to criteria of ICD-10,” the researchers concluded.

“A cut-off ≥2 on the GDS-5 and ≥4 on the HADS-D should thus lead to further diagnostic examination of depressive symptoms.”


Eriksen S, Bjørkløf GH, Helvik AS, Larsen M, Engedal K. The validity of the Hospital Anxiety and Depression scale and the Geriatric Depression scale-5 in home-dwelling old adults in Norway. J Affect Disord. 2019;256:380-385.