Assessment of anxiety in long-term care: examination of the Geriatric Anxiety Inventory (GAI) and its short form

Abstract

Accurate assessment of anxiety in later life is critical, as anxiety among older adults is associated with social and functional impairment and poorer quality of life. The Geriatric Anxiety Inventory (GAI) and the GAI-Short Form (GAI-SF) were designed to detect anxiety symptoms among community-dwelling older adults, but the usefulness of the GAI and GAI-SF in long-term care is unknown. The present study examined the psychometric properties of the GAI and GAI-SF among residents at a long-term care facility. Seventy-five nursing home residents completed the GAI and measures of depression, executive functioning, and adaptive functioning. The mean age of residents was 69.60 years (SD = 10.76). Psychiatric diagnoses included dementia, psychotic disorders, mood disorders, anxiety disorders, substance abuse, sleep disorders, and mental retardation. Internal consistency of the GAI was good (α = 0.92) and the GAI-SF was adequate (α = 0.73). GAI and GAI-SF scores were moderately correlated with depression scores, and weakly correlated with adaptive functioning scores and executive functioning scores, suggesting discriminant validity. Logistic regression analyses were conducted with GAI and GAI-SF scores predicting an anxiety disorders diagnosis. Results provided support for the predictive validity of the GAI and GAI-SF. Sensitivity, specificity, and the percentage of individuals correctly classified at various cut-off scores were also calculated. Both the GAI and GAI-SF appear to be useful tools for assessing anxiety among nursing home residents with psychological disorders. The GAI-SF may be a viable replacement for the GAI as a screener for anxiety in long-term care.