The GDS-15 is a fifteen-item yes/no screen for depressive symptoms in older adults, asking how the person has felt over the past week. It was built specifically for later life: it deliberately omits the somatic symptoms - sleep disturbance, fatigue, appetite change - that overlap with normal ageing and physical illness, and which inflate scores on general depression scales in this population. Five items are phrased positively and reverse-scored; the total runs from 0 to 15, with higher scores indicating more depressive symptoms.
The yes/no format is a design choice, not a simplification. Graded response options (such as the four-point frequency scale of the PHQ-9) can be difficult for people with mild cognitive impairment or sensory limitations; a binary answer is quicker and less error-prone. The GDS-15 screens for the presence of depression - it is not a diagnostic instrument, and a positive screen calls for clinical assessment.
02 - Origin & purpose
Where it comes from.
The original 30-item Geriatric Depression Scale was developed by Yesavage and colleagues in 1982-83 as the first depression scale designed from scratch for older adults, with items empirically selected for their ability to discriminate depressed from non-depressed elderly people 1. Sheikh and Yesavage published the 15-item short form in 1986, selecting the items with the highest correlation with depressive symptoms in the validation work, so that the screen could fit into a routine consultation 2.
The scale was developed partly with United States federal support and is in the public domain; Stanford University's Aging Clinical Research Center distributes the original English versions and many translations without fee. That has made it one of the most widely used depression screens in geriatric medicine, care homes and old-age psychiatry worldwide.
03 - Scoring & cutoffs
How scoring works.
Each of the fifteen items scores 0 or 1; items 1, 5, 7, 11 and 13 are positively worded and score a point for a "no" answer. The standard cutoff is ≥5, which meta-analytic evidence puts at a pooled sensitivity of 0.89 and specificity of 0.77 for major depression 4. The severity bands shown below (0-4 normal, 5-8 mild, 9-11 moderate, 12-15 severe) are widely used conventions for grading a positive screen rather than validated diagnostic thresholds; any score of 5 or more warrants a fuller clinical assessment.
Score
Severity
Interpretation
0–4
Normal
No depression indicated.
5–8
Mild
Mild depressive symptoms suggested.
9–11
Moderate
Moderate depression suggested.
12–15
Severe
Severe depression suggested. Further assessment recommended.
04 - Validation evidence
How well it performs.
Diagnostic accuracy has been summarised in two systematic reviews. Krishnamoorthy and colleagues (2020) pooled studies at the standard ≥5 cutoff and found sensitivity 0.89 and specificity 0.77 4; an earlier meta-analysis of brief GDS versions (Pocklington 2016) reported pooled sensitivity 0.86 and specificity 0.79 with an area under the curve of 0.90 3. Internal consistency is good, with Cronbach's alpha around 0.88 in validation studies. Among very old adults, the scale remains usable in mild-to-moderate cognitive impairment: a Swedish study found it informative down to MMSE scores of about 10 5 - though most diagnostic-accuracy studies excluded people with significant cognitive impairment, so accuracy estimates in that group are less secure.
0.89
SENSITIVITY (≥5)
0.77
SPECIFICITY (≥5)
0.90
AUC (BRIEF GDS FORMS)
≈0.88
CRONBACH'S α
05 - How it compares
How it compares to the alternatives.
Instrument
Items
Time
When to reach for it
GDS-15
15
~5 min
Designed for later life; omits somatic items that mislead in older, medically ill patients. Public domain.
-Diagnosis: a positive screen needs clinical assessment.
-Tracking week-to-week treatment response, where the binary items make it less sensitive to change than graded scales.
-Severe dementia, where self-report becomes unreliable.
-Suicide-risk assessment: it contains no suicidal-ideation item, so risk must be asked about separately.
07 - Confidence & precision
Reading the score with care.
No widely accepted standard error of measurement or minimal clinically important difference has been established for the GDS-15, so treat small score changes cautiously. Precision is best framed in screening terms: at the ≥5 cutoff roughly one depressed patient in ten screens negative (sensitivity 0.89), and about one in four positive screens will not have major depression on formal assessment (specificity 0.77). Movement of a point or two near the cutoff should prompt a conversation, not a conclusion.
08 - Limitations
What it cannot tell you.
Most validation studies excluded people with significant cognitive impairment, so accuracy in dementia is uncertain and self-report becomes unreliable as impairment progresses. Specificity is modest - around a quarter of positive screens are false positives, so it over-identifies relative to diagnostic interview. The severity bands above the cutoff are conventions rather than validated thresholds. The binary format that makes it easy to answer also makes it comparatively insensitive to change, limiting its value for monitoring treatment response. And it omits suicidal ideation entirely, which must always be assessed separately in depressed older adults.
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