Screening for depression and anxiety among older Chinese immigrants living in Western countries: The use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI)

Asia Pac Psychiatry. 2016 Mar;8(1):32-43. doi: 10.1111/appy.12191. Epub 2015 May 22.


Background: Depression and anxiety are two common mental health problems among older people. There is evidence that using well-validated screening tools can improve detection of depression and anxiety among this group. The review explored the use of the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI) for screening depression and anxiety among older Chinese immigrants, one of the largest and fastest growing groups of older immigrants in Western society. It focused on the GDS and GAI because both are designed specifically for older people.

Methods: Online literature searches were conducted in MEDLINE, CINAHL, and PsycINFO. A narrative approach was used to review included papers.

Results: A total of 21 articles were included. There were limited data on anxiety among older Chinese immigrants, with only one unpublished report identified. There were 13 studies (20 articles) using the GDS with this group. Results of these studies indicated that the GDS is a reliable tool in this population; however, there was limited validity data. Two versions of the GDS-15 have been used with older Chinese immigrants, including the standard GDS-15 and Mui's GDS-15. Prevalence of depression ranged between 20% and 30% in most reviewed studies.

Discussion: Results of this review have practical implications for clinicians in their use of these tools with older Chinese immigrants in Western countries, such as the different GDS versions. It also suggests a number of directions for future research, such as the inclusion of clinical samples and consideration of the diversity within this group.

Keywords: Chinese; anxiety; depression; immigrant; older people.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anxiety / diagnosis*
  • Anxiety / epidemiology
  • Anxiety Disorders / diagnosis*
  • Anxiety Disorders / epidemiology
  • China / ethnology
  • Depression / diagnosis*
  • Depression / epidemiology
  • Depressive Disorder / diagnosis*
  • Depressive Disorder / epidemiology
  • Emigrants and Immigrants / psychology*
  • Humans
  • Mass Screening
  • Middle Aged
  • Prevalence
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Western World