The Geriatric Mental State Examination in the 21st century

Abstract

The Geriatric Mental State Examination (GMS) is now established as one of the most commonly used mental health assessments for older people. Its strengths lie in extensive validity studies, high inter-rater reliability, accessibility to trained raters, irrespective of professional background and its continual evolution and adaptation. Its computerisation, association with supplementary instruments and support by a diagnostic algorithm provides a comprehensive diagnostic system and syndrome profile for each subject. The instrument has been validated against most major diagnostic systems and has been used as outcome measures in intervention studies. It has been translated into numerous languages and validated as a diagnostic instrument in various cultures. Such studies have exposed weaknesses, including the over diagnoses of organic states in populations with poorly developed education. On-going studies continue to address these issues, providing a culture sensitive instrument enabling unique trans-cultural research in a relatively under-researched field.

Co-occurrence of anxiety and depression amongst older adults in low- and middle-income countries: findings from the 10/66 study

“…This examination has been used successively translated and adapted to different cultures in many international studies, with demonstration of robust reliability and validity (Copeland et al 2002).…”

Age-Related Metabolic Profiles in Cognitively Healthy Elders: Results from a Voxel-Based [18F]Fluorodeoxyglucose–Positron-Emission Tomography Study with Partial Volume Effects Correction: Fig 1.

“…27 This protocol included the following instruments: the Community Screening Interview for Dementia 28 ; an adapted version of the CERAD 10-word list 29 ; the animal naming verbal fluency task from the CERAD; the Geriatric Mental State 30 ; a structured neurologic assessment; and a structured cardiology evaluation. The criterion for cognitive impairment was defined as a performance in the cognitive battery 1.5 SDs below the mean performance obtained from all subjects between 65 and 75 years of age from the original SPAH sample.…”

Ethnic Variations in Dementia: The Contributions of Cardiovascular, Psychosocial and Neuropsychological Factors

“…Scores of the symptom components from the GMS interview are used to derive scores (0-4 or 0-5) for diagnostic clusters, which are then compared according to a hierarchy of diagnoses (organic brain syndrome, schizophrenia, mania, major and neurotic depression, and obsessional, hypochondriacal, phobic and anxiety neuroses) to provide main and subsidiary diagnoses. The GMS has been demonstrated to be able to generate accurate diagnoses of clinical dementia, depression and anxiety in elderly people including those with chronic diseases [21] . The system provides diagnoses of recent psychiatric disorders by generating 5 levels of diagnostic confidence for determining 'caseness'.…”

“…All subjects were administered the Geriatric Mental State (GMS) schedule, a standardized, semistructured diagnostic interview instrument used in many international studies to assess psychopathology in older adults [20][21][22][23] . The instrument has been validated against other diagnostic systems including the Diagnostic and Statistical Manual of Mental Disorders (DSM), and has also been used as a gold standard criterion against which to validate other measures of cognitive impairment or dementia.…”