Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-22T19:40:01.999Z Has data issue: false hasContentIssue false
  • English
  • Français

Assessment of anxiety in older adults: psychometric properties and relationships with self-reported functional impairment

Published online by Cambridge University Press:  28 August 2019

Alyssa N. De Vito Open the ORCID record for Alyssa N. De Vito [Opens in a new window] ,
Matthew Calamia ,
Daniel Weitzner  and
John P. K. Bernstein
Alyssa N. De Vito*
Affiliation:
Department of Psychology, Louisiana State University, Baton Rouge, LA70803, USA
Matthew Calamia
Affiliation:
Department of Psychology, Louisiana State University, Baton Rouge, LA70803, USA
Daniel Weitzner
Affiliation:
Department of Psychology, Louisiana State University, Baton Rouge, LA70803, USA
John P. K. Bernstein
Affiliation:
Department of Psychology, Louisiana State University, Baton Rouge, LA70803, USA
*
Correspondence should be addressed to: Alyssa De Vito, Department of Psychology, Louisiana State University, 236 Audubon Hall, Baton Rouge, LA 70803, USA. Phone: 1+ (225) 578-2456. Fax: 1+ (225) 578-4125. Email: [email protected].
Get access

Abstract

Objective:

The current study aimed to examine the psychometric properties of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and the Geriatric Anxiety Scale (GAS). This study also aimed to determine the relationships of these measures with two measures of functional ability and impairment: the Barkley Functional Impairment Scale (BFIS) and the Everyday Cognition Scale (E-Cog).

Design:

Confirmatory factor analyses (CFA) were used to analyze the factor structures of the GAI and GAS in older adults. Tests for dependent correlations were used to examine the relationship between anxiety scales and functioning.

Setting:

Amazon’s Mechanical Turk

Participants:

348 participants (aged 55–85, M= 62.75 (4.8), 66.5% female) with no history of psychosis or traumatic brain injury.

Results:

CFAs supported the previously demonstrated bifactor solution for the GAI. For the GAS, the previously demonstrated three-factor model demonstrated a good-to-excellent fit. Given the high correlation between the cognitive and affective factors (r =.89), a bifactor solution was also tested. The bifactor model of the GAS was found to be primarily unidimensional. Tests for dependent correlations revealed that the GAS demonstrated stronger relationships with measures of self-reported functional impairment than the GAI.

Conclusions:

The current study provides further psychometric validation of the factor structure of two geriatric anxiety measures in an older adult sample. The results support previous work completed on the GAI and the GAS. The GAS was more strongly correlated with self-reported functional impairment than the GAI, which may reflect differences in content in the two measures.

Keywords

geriatric anxiety scalegeriatric anxiety inventoryolder adultspsychometric propertiesfunctional impairment
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 4: Issue Theme: Serious Mental Illnesses in Older Adults , April 2020 , pp. 505 - 513
Copyright
© International Psychogeriatric Association 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Barber, S. J. and Lee, S. R. (2016). Stereotype threat lowers older adults’ self-reported hearing abilities. Gerontology, 62, 81–85.CrossRefGoogle Scholar
Barkley, R. A. (2011). Barkley Functional Impairment Scale (BFIS for Adults). New York, NY: Guilford Press.Google Scholar
Beck, A. T. and Steer, R. A. (1991). Relationship between the beck anxiety inventory and the Hamilton anxiety rating scale with anxious outpatients. Journal of Anxiety Disorders, 5, 213–223.CrossRefGoogle Scholar
Behar, E., Alcaine, O., Zuellig, A. R. and Borkovec, T. D. (2003). Screening for generalized anxiety disorder using the Penn State Worry Questionnaire: A receiver operating characteristic analysis. Journal of Behavior Therapy and Experimental Psychiatry, 34, 25–43.CrossRefGoogle ScholarPubMed
Bryant, C., Jackson, H. and Ames, D. (2008). The prevalence of anxiety in older adults: methodological issues and a review of the literature. Journal of Affective Disorders, 109, 233–250.CrossRefGoogle Scholar
Buhrmester, M., Kwang, T. and Gosling, S. D. (2011). Amazon’s Mechanical Turk: a new source of inexpensive, yet high-quality, data?. Perspectives on Psychological Science, 6, 3–5.CrossRefGoogle ScholarPubMed
Buikema, E. R. (2017). Examining the Factor Structure of the Geriatric Anxiety Inventory with a Clinically Referred Older Adult Population (Doctoral Dissertation). Available at: https://search.proquest.com/docview/1955107732?pq-origsite=gscholar.Google Scholar
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults: the National Comorbidity Survey Replication. Archives of General Psychiatry, 67, 489–496.CrossRefGoogle ScholarPubMed
Byrne, G. J., Pachana, N. A., Goncalves, D. C., Arnold, E., King, R. and Keat Khoo, S. (2010). Psychometric properties and health correlates of the Geriatric Anxiety Inventory in Australian community-residing older women. Aging & Mental Health, 14, 247–254.CrossRefGoogle ScholarPubMed
Chandler, J. and Shapiro, D. (2016). Conducting clinical research using crowdsourced convenience samples. Annual Review of Clinical Psychology, 12, 53–81.CrossRefGoogle ScholarPubMed
Clarke, D. M. and Currie, K. C. (2009). Depression, anxiety and their relationship with chronic diseases: a review of the epidemiology, risk and treatment evidence. Medical Journal of Australia, 190, S54–S60.CrossRefGoogle ScholarPubMed
De Vito, A. N., Calamia, M., Roye, S., Bernstein, J. P.K. and Castagna, P. (2018). Factor structure of the attentional control scale in younger and older adults: Relationships with anxiety and depression. Journal of Psychopathology and Behavioral Assessment, 41, 60–68.CrossRefGoogle Scholar
Diefenbach, G. J., Bragdon, L. B., and Blank, K. (2014). Geriatric anxiety inventory: factor structure and associations with cognitive status. The American Journal of Geriatric Psychiatry, 22, 1418–1426.CrossRefGoogle ScholarPubMed
Diefenbach, G. J., Tolin, D. F., Meunier, S. A. and Gilliam, C. M. (2009). Assessment of anxiety in older home care recipients. The Gerontologist, 49, 141–153.CrossRefGoogle ScholarPubMed
Dueber, D. M. (2017). Bifactor Indices Calculator: A Microsoft Excel-based tool to calculate various indices relevant to bifactor CFA models. doi: 10.13023/edp.tool.01.CrossRefGoogle Scholar
Farias, S. T., Mungas, D., Harvey, D. J., Simmons, A., Reed, B. R. and DeCarli, C. (2011). The measurement of everyday cognition: development and validation of a short form of the Everyday Cognition scales. Alzheimer’s & Dementia, 7, 593–601.CrossRefGoogle Scholar
Farias, S. T.et al. (2008). The measurement of everyday cognition (ECog): scale development and psychometric properties. Neuropsychology, 22, 531–544.CrossRefGoogle ScholarPubMed
Fusar-Poli, P.et al. (2012). Predicting psychosis: meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry, 69, 220–229.CrossRefGoogle ScholarPubMed
Gatti, A.et al. (2018). An investigation of the psychometric properties of the Geriatric Anxiety Scale (GAS) in an Italian sample of community-dwelling older adults. Aging & Mental Health, 22, 1176–1184.CrossRefGoogle Scholar
Gould, C. E., Beaudreau, S. A. and Huh, J. W. (2013). A veterans health administration imperative: recommendations for detecting anxiety in older adults. Federal Practioner, 30, 35–42.Google Scholar
Gould, C. E., Segal, D. L., Yochim, B. P., Pachana, N. A., Byrne, G. J. and Beaudreau, S. A. (2014). Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale. Journal of Anxiety Disorders, 28, 804–811.CrossRefGoogle ScholarPubMed
Grenier, S.et al. (2011). The impact of DSM-IV symptom and clinical significance criteria on the prevalence estimates of subthreshold and threshold anxiety in the older adult population. The American Journal of Geriatric Psychiatry, 19, 316–326.CrossRefGoogle ScholarPubMed
Haller, H., Cramer, H., Lauche, R., Gass, F. and Dobos, G. J. (2014). The prevalence and burden of subthreshold generalized anxiety disorder: a systematic review. BMC Psychiatry, 14, 128.CrossRefGoogle ScholarPubMed
Hoffman, D. L., Dukes, E. M. and Wittchen, H. U. (2008). Human and economic burden of generalized anxiety disorder. Depression and Anxiety, 25, 72–90.CrossRefGoogle ScholarPubMed
Hydock, C. (2018). Assessing and overcoming participant dishonesty in online data collection. Behavior Research Methods, 50, 1563–1567.CrossRefGoogle ScholarPubMed
Johnco, C., Knight, A., Tadic, D. and Wuthrich, V. M. (2015). Psychometric properties of the Geriatric Anxiety Inventory (GAI) and its short-form (GAI-SF) in a clinical and non-clinical sample of older adults. International Psychogeriatrics, 27, 1089–1097.CrossRefGoogle Scholar
Julian, L. J. (2011). Measures of anxiety: State‐Trait Anxiety Inventory (STAI), Beck Anxiety Inventory (BAI), and Hospital Anxiety and Depression Scale‐Anxiety (HADS‐A). Arthritis Care & Research, 63, S467–S472.CrossRefGoogle Scholar
Kelley, P. G. (July 2010). Conducting usable privacy & security studies with amazon’s mechanical turk. In Symposium on Usable Privacy and Security (SOUPS). Redmond, WA.Google Scholar
Lenze, E. J.et al. (2001). The association of late-life depression and anxiety with physical disability: a review of the literature and prospectus for future research. The American Journal of Geriatric Psychiatry, 9, 113–135.CrossRefGoogle ScholarPubMed
Löwe, B., Spitzer, R. L., Williams, J. B., Mussell, M., Schellberg, D. and Kroenke, K. (2008). Depression, anxiety and somatization in primary care: syndrome overlap and functional impairment. General Hospital Psychiatry, 30, 191–199.CrossRefGoogle ScholarPubMed
Meyer, T. J., Miller, M. L., Metzger, R. L. and Borkovec, T. D. (1990). Development and validation of the Penn State worry questionnaire. Behaviour Research and Therapy, 28, 487–495.CrossRefGoogle ScholarPubMed
Molde, H.et al. (2019). A cross-national analysis of the psychometric properties of the Geriatric Anxiety Inventory (GAI). The Journals of Gerontology: Series B. doi: 10.1093/geronb/gbz002.CrossRefGoogle Scholar
Molde, H.et al. (2017). A Bifactor and item response analysis of the geriatric anxiety inventory. International Psychogeriatrics, 29, 1647–1656.CrossRefGoogle ScholarPubMed
Moore, E. L., Terryberry-Spohr, L. and Hope, D. A. (2006). Mild traumatic brain injury and anxiety sequelae: a review of the literature. Brain Injury, 20, 117–132.CrossRefGoogle ScholarPubMed
Mueller, A. E.et al. (2015). Geriatric Anxiety Scale: item response theory analysis, differential item functioning, and creation of a ten-item short form (GAS-10). International Psychogeriatrics, 27, 1099–1111.CrossRefGoogle Scholar
Múthen, L. K. and Múthen, B. O. (2007). Mplus statistical analysis. Los Angeles, CA: Múthen and Múthen Google Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the Geriatric Anxiety Inventory. International Psychogeriatrics, 19, 103–114.CrossRefGoogle ScholarPubMed
Picconi, L., Balsamo, M., Palumbo, R. and Fairfield, B. (2018). Testing factor structure and measurement invariance across gender with Italian Geriatric Anxiety Scale. Frontiers in Psychology, 9, 1164.CrossRefGoogle ScholarPubMed
Porensky, E. K.et al. (2009). The burden of late-life generalized anxiety disorder: effects on disability, health-related quality of life, and healthcare utilization. The American Journal of Geriatric Psychiatry, 17, 473–482.CrossRefGoogle ScholarPubMed
Rapaport, M. H., Clary, C., Fayyad, R. and Endicott, J. (2005). Quality-of-life impairment in depressive and anxiety disorders. American Journal of Psychiatry, 162, 1171–1178.CrossRefGoogle ScholarPubMed
Reise, S. P., Bonifay, W. E. and Haviland, M. G. (2013). Scoring and modeling psychological measures in the presence of multidimensionality. Journal of Personality Assessment, 95, 129–140. doi: 10.1080/00223891.2012.725437.CrossRefGoogle ScholarPubMed
Rodriguez, A., Reise, S. P. and Haviland, M. G. (2016a). Evaluating bifactor models: calculating and interpreting statistical indices. Psychological Methods, 21, 137–150. doi: 10.1037/met0000045.CrossRefGoogle ScholarPubMed
Rodriguez, A., Reise, S. P. and Haviland, M. G. (2016b). Applying bifactor statistical indices in the evaluation of psychological measures. Journal of Personality Assessment, 98, 223–237.CrossRefGoogle ScholarPubMed
Segal, D. L., June, A., Payne, M., Coolidge, F. L. and Yochim, B. (2010). Development and initial validation of a self-report assessment tool for anxiety among older adults: The Geriatric Anxiety Scale. Journal of Anxiety Disorders, 24, 709–714.CrossRefGoogle ScholarPubMed
Shapiro, D. N., Chandler, J. and Mueller, P. A. (2013). Using Mechanical Turk to study clinical populations. Clinical Psychological Science, 1, 213–220.CrossRefGoogle Scholar
Stuck, A. E., Walthert, J. M., Nikolaus, T., Büla, C. J., Hohmann, C. and Beck, J. C. (1999). Risk factors for functional status decline in community-living elderly people: a systematic literature review. Social Science & Medicine, 48, 445–469.CrossRefGoogle ScholarPubMed
Therrien, Z. and Hunsley, J. (2012). Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging & Mental Health, 16, 1–16.CrossRefGoogle ScholarPubMed
Watson, D. and O’Hara, M. W. (2017). Understanding the emotional disorders: A symptom-level approach based on the IDAS-II. New York, NY: Oxford University Press.CrossRefGoogle Scholar
Watson, D.et al. (2012). Development and validation of the Inventory of Depression and Anxiety Symptoms (IDAS). Psychological Assessment, 19, 253–268.CrossRefGoogle Scholar
Webb, C. A., Cui, R., Titus, C., Fiske, A. and Nadorff, M. R. (2018). Sleep disturbance, activities of daily living, and depressive symptoms among older adults. Clinical Gerontologist, 41, 172–180.CrossRefGoogle ScholarPubMed
Wetherell, J. L. and Gatz, M. (2005). The Beck Anxiety Inventory in older adults with generalized anxiety disorder. Journal of Psychopathology and Behavioral Assessment, 27, 17–24.CrossRefGoogle Scholar
Wetherell, J. L., Thorp, S. R., Patterson, T. L., Golshan, S., Jeste, D. V. and Gatz, M. (2004). Quality of life in geriatric generalized anxiety disorder: a preliminary investigation. Journal of Psychiatric Research, 38, 305–312.CrossRefGoogle ScholarPubMed
Wolitzky‐Taylor, K. B., Castriotta, N., Lenze, E. J., Stanley, M. A. and Craske, M. G. (2010). Anxiety disorders in older adults: a comprehensive review. Depression and Anxiety, 27, 190–211.CrossRefGoogle ScholarPubMed
Yochim, B. P., Mueller, A. E., June, A. and Segal, D. L. (2010). Psychometric properties of the geriatric anxiety scale: comparison to the beck anxiety inventory and geriatric anxiety inventory. Clinical Gerontologist, 34, 21–33.CrossRefGoogle Scholar
Yochim, B. P., Mueller, A. E. and Segal, D. L. (2013). Late life anxiety is associated with decreased memory and executive functioning in community dwelling older adults. Journal of Anxiety Disorders, 27, 567–575.CrossRefGoogle ScholarPubMed
Yohannes, A. M., Willgoss, T. G., Baldwin, R. C. and Connolly, M. J. (2010). Depression and anxiety in chronic heart failure and chronic obstructive pulmonary disease: prevalence, relevance, clinical implications and management principles. International Journal of Geriatric Psychiatry, 25, 1209–1221.CrossRefGoogle ScholarPubMed
Zigmond, A. S. and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle ScholarPubMed