Table 1. Summary of anxiety assessment measures examined in older adult samples.
Measure Items Administration
Beck Anxiety Inventory (BAI) 21 < 3 mina Intensity of anxiety. Use to assess panic,
Brief Symptoms Inventory
18 4 minc Anxiety ( 6 items), depression, and somatic
symptoms. One question for panic.
Generalized Anxiety Disorder
Screening Questions (GAD-2)d
2 1 mina Screen for GAD only
Generalized Anxiety Disorder
9 < 5 mina Screen for GAD only
Geriatric Anxiety Scale (GAS) 30 < 10 min Anxiety symptoms. Three subscales: so-
matic, cognitive, affective.
Geriatric Anxiety Inventory (GAI)d 20 < 3 mina Worry and general anxiety symptoms.
Simple, dichotomous response scale offers potential for use with older adults with
mild cognitive impairment.
Hospital Anxiety and Depression
14 5 min Anxiety and depression with separate
subscales ( 7 items each). Does not con-
tain somatic items.
Penn State Worry Questionnaire
8 < 5 mine Worry. Not recommended for older adults
with mild cognitive impairment.
a The administration time was based on oral administration, which was sometimes accompanied by presentation of a visual aid for the response categories
(eg, Likert-type scale) to older, homebound participants. 27
b Recommended measures based on our review findings.
c The administration time was for the completion of the measure with paper and pencil per manual. 19 Administration time is not specific to older adults.
d Recommended as best overall measure.
e The administration time for the PSWQ-A is estimated at < 5 minutes. The oral administration of the 16-item PSWQ was 5 minutes in duration for older,
homebound participants. 27
Availability is based on provider’s access to measures through the nationally available Mental Health Assistant in CPRS. Other proprietary measures
available in the VHA that may be purchased and used by local sites are not noted here.
CPRS = Computerized Patient Record System; GAD = generalized anxiety disorder.
was developed for providers treating older veterans with anxiety and
for the veterans themselves. This
manual can be used to guide CBT
treatment and is being disseminated
in VHA. 15 Pharmacotherapy, specifically, selective serotonin reuptake inhibitors (SSRIs), is another effective
treatment for late-life anxiety disorders. 16, 17 In order for older veterans
to access treatment for anxiety, better
assessment is needed to improve detection within primary care.
IDENTIFICATION OF ANXIETY
It is important to obtain informa-
tion to facilitate detection of anxiety
in older adults. For example, symp-
toms differ in older adults compared
with younger adults. There are im-
portant factors to consider, such as
how medical and social contexts
might impact how older adults with
anxiety present. Therefore, informa-
tion should be gathered from several
sources, including a clinical inter-
view and a thorough review of the
patient’s medical records and medi-
cation lists. Recommendations for
how to obtain that information are
Anxiety can be grouped into
3 types of symptoms: cognitive, behavioral, and physiological or somatic. With cognitive symptoms,
older adults may present with
worry but characterize their worry
as “concerns.” 5 Adopting the patient’s language used during an interview helps establish rapport and