Development and validation of the Geriatric Anxiety Inventory

Pachana, Nancy A.; Byrne, Gerard; Siddle, Helen; Koloski, Natasha A.; Harley, Emma; Arnold, Elizabeth Mayfield

doi:10.1017/s1041610206003504

Cited by 651 publications

(637 citation statements)

References 48 publications

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“…Scores range from 0 to 20, with higher scores indicative of greater anxiety severity. Findings from previous studies provide evidence for excellent GAI score test-retest reliability (r = 0.93 and 0.91) and excellent internal consistency [18,23]. We examined the psychometric properties of the GAI and found good internal consistency as measured with the Kuder-Richardson 20 coefficient (KR-20 = 0.82).…”

Section: Methodsmentioning

confidence: 80%

“…We examined the psychometric properties of the GAI and found good internal consistency as measured with the Kuder-Richardson 20 coefficient (KR-20 = 0.82). Additional studies provide evidence of convergent validity [18,[23][24] and discriminant validity [18].…”

Section: Methodsmentioning

confidence: 97%

“…The GAI is a 20-item measure of anxiety that uses a dichotomous "agree" or "disagree" response scale [18]. Scores range from 0 to 20, with higher scores indicative of greater anxiety severity.…”

Section: Methodsmentioning

confidence: 99%

“…The Geriatric Anxiety Inventory (GAI) [18] was identified as the best overall anxiety screen for older VA patients due to the strong psychometric support and the clear administration and scoring instructions. The GAI is a 20-item, dichotomously scored measure that can be administered in less than 3 min.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

et al. 2016

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Abstract-Anxiety disorders are common and debilitating in older individuals, yet anxiety is often not formally assessed in primary care. We conducted a quality improvement project to examine the feasibility of implementing a brief anxiety assessment, the Geriatric Anxiety Inventory (GAI), in a Department of Veterans Affairs geriatric primary care clinic. We compared the GAI with a depression assessment, the 15-item Geriatric Depression Scale (GDS-15). Fifty older Veterans (mean age = 78.5 +/-7.4 yr) completed the GAI and GDS-15. Mean completion time and feedback to patients was brief (6.20 min; n = 10). Good internal consistency (alpha = 0.82) was found for GAI scores. Patients with psychiatric diagnoses obtained significantly higher GAI scores (mean = 4.73 +/-1.15) compared with patients without psychiatric diagnoses (mean = 1.15 +/-1.86, t(11.46) = -3.10, p = 0.01). Findings suggest that the GAI is acceptable to patients but may not be suitable for differentiating anxiety symptoms or disorders from depression. Interdisciplinary team members continued to implement the GAI after project completion to screen for and track anxiety symptoms in our geriatric primary care patients. Detecting anxiety with the GAI had the benefit of allowing providers to initiate conversations about available treatments and track symptoms as part of noting treatment progress.

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Section: Methodsmentioning

confidence: 80%

Section: Methodsmentioning

confidence: 97%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

et al. 2016

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“…It is only very recently that instruments devised specifically to measure anxiety and anxiety disorders among older people have been developed and tested. Prominent examples are the Geriatric Anxiety Inventory (GAI, Pachana et al, 2007) and the Geriatric Anxiety Scale (GAS, Segal et al, 2010). Both instruments are put to the test in this issue and both perform very well (Mueller et al, 2015, Johnco et al, 2015.…”

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confidence: 99%

Late-life anxiety is coming of age

Beekman

Voshaar²,

Pachana

2015

Int. Psychogeriatr.

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Anxiety is an adaptive human experience that may occur at all ages and serves to help draw attention to, avoid or cope with immanent threat and danger. Given its evolutionary importance, it has strong genetic and biological underpinnings, and when it serves that adaptive function for the organism, anxiety may be viewed as useful. However, complex adaptive systems, such as our adaptation to threat or stress, by definition provide many and often interrelated points of breakdown or dysregulation, which, if sustained, may lead to psychopathology. Anxiety has been described as a common currency for psychopathology, indicating that it is a first line and universal way for us to respond to stress and threat. It is more or less prominent in patients diagnosed with practically all psychiatric or neurodegenerative disorders. This has lead to the inclusion of anxiety as a cross-cutting symptom measure in the development of DSM-5 (APA, 2013). Given that they are rooted in a complex adaptive system that has many potential points of impact to develop pathology, it is not surprising that anxiety disorders are extremely heterogeneous. This heterogeneity of anxiety disorders pertains to symptomatology, etiology and outcomes, and poses great challenges to both research and clinical practice.

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Reduction of Inappropriate Benzodiazepine Prescriptions Among Older Adults Through Direct Patient Education

et al. 2014

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Campaign recommends against the use of benzodiazepine drugs for adults 65 years and older. The effect of direct patient education to catalyze collaborative care for reducing inappropriate prescriptions remains unknown. OBJECTIVE To compare the effect of a direct-to-consumer educational intervention against usual care on benzodiazepine therapy discontinuation in community-dwelling older adults. DESIGN, SETTING, AND PARTICIPANTS Cluster randomized trial (EMPOWER [Eliminating Medications Through Patient Ownership of End Results] study [2010-2012, 6-month follow-up]). Community pharmacies were randomly allocated to the intervention or control arm in nonstratified, blocked groups of 4. Participants (303 long-term users of benzodiazepine medication aged 65-95 years, recruited from 30 community pharmacies) were screened and enrolled prior to randomization: 15 pharmacies randomized to the educational intervention included 148 participants and 15 pharmacies randomized to the "wait list" control included 155 participants. Participants, physicians, pharmacists, and evaluators were blinded to outcome assessment. INTERVENTIONS The active arm received a deprescribing patient empowerment intervention describing the risks of benzodiazepine use and a stepwise tapering protocol. The control arm received usual care. MAIN OUTCOMES AND MEASURES Benzodiazepine therapy discontinuation at 6 months after randomization, ascertained by pharmacy medication renewal profiles. RESULTS A total of 261 participants (86%) completed the 6-month follow-up. Of the recipients in the intervention group, 62% initiated conversation about benzodiazepine therapy cessation with a physician and/or pharmacist. At 6 months, 27% of the intervention group had discontinued benzodiazepine use compared with 5% of the control group (risk difference, 23% [95% CI, 14%-32%]; intracluster correlation, 0.008; number needed to treat, 4). Dose reduction occurred in an additional 11% (95% CI, 6%-16%). In multivariate subanalyses, age greater than 80 years, sex, duration of use, indication for use, dose, previous attempt to taper, and concomitant polypharmacy (10 drugs or more per day) did not have a significant interaction effect with benzodiazepine therapy discontinuation. CONCLUSIONS AND RELEVANCE Direct-to-consumer education effectively elicits shared decision making around the overuse of medications that increase the risk of harm in older adults. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01148186

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Development and validation of the Geriatric Anxiety Inventory

Abstract: Background:

Cited by 651 publications

References 48 publications

Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

Implementation of a brief anxiety assessment and evaluation in a Department of Veterans Affairs geriatric primary care clinic

Late-life anxiety is coming of age

Reduction of Inappropriate Benzodiazepine Prescriptions Among Older Adults Through Direct Patient Education

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