UQ Psychology’s Professor Nancy Pachana has developed the Geriatric Anxiety Inventory (GAI) to assess anxiety in older patients. In close collaboration with Associate Professor Gerard Byrne from UQ’s School of Medicine, this research is helping to ease stress for older adults and those who care for them.
According to Dr Pachana, there were no generally accepted older-adult specific tests of self-reported anxiety symptoms before the GAI.
“Anxiety is very common in older people—much more common than depression,” said Dr Pachana. “And yet until recently there has been little research on treatments and even less on measuring anxiety in older adults.”
Dr Pachana said that assessing anxiety in older people, particularly those entering or residing in long-term care, can be difficult because other age-related processes can overshadow symptoms of anxiety.
“Older adults may be experiencing some level of cognitive impairment or co-existing medical condition, which can be difficult to distinguish from the physical and cognitive symptoms of an anxiety disorder,” said Dr Pachana.
Many self-report tests that have been used in the past with older adults were originally developed on younger populations, and so are less than ideal in reflecting the age-specific symptoms of anxiety. Many of these tests are long and impractical for use in clinical settings—some have complex response options that may be confusing for older adults with mild memory problems.
The GAI is already brief at 20 items, but a shorter 5 item version has been developed for use in epidemiological studies. The responses options are limited to “agree” or “disagree” and the wording is straightforward, allowing the GAI to be administered by another person if patients have visual problems or reading difficulties. The GAI can also be administered over the telephone.
“We ask patients questions like ‘Do you think of yourself as a nervous person?’ and ‘Do you find it hard to relax?’,” said Dr Pachana.
Such questions largely avoid terms like “anxiety” which are not often used by older people to describe their own feelings.
Clinicians and researchers across Australia, as well as other English-speaking countries including New Zealand, Canada, the United Kingdom and the United States, are using the GAI.
The GAI has been so successful, it has been translated into more than twenty languages—including Polish, German, Italian, Swedish, Spanish, Japanese, French, Portuguese, Dutch and Turkish.
“My colleague Gerard Byrne and I are now working on a version of the GAI for caregivers, called the Informant Questionnaire for Anxiety in Dementia or the IQAD,” said Dr Pachana. “This will help in picking up anxiety disorders in persons with dementia, who often can’t clearly describe their distress, so that they may receive proper treatment.”
An international validity trial of the IQAD in memory clinics is being run in Australia, the Netherlands, New Zealand and Portugal, and scheduled for completion in late 2011.
GAI is free for use by individual clinicians or researchers. Further information can be found on the GAI website