Geriatric Depression Scale

First Name *

Last Name *

DOB: *

Are you basically satisfied with your life? *

YesNo

Are you afraid that something bad is going to happen to you? *

YesNo

Do you think it is wonderful to be alive? *

YesNo

Have you dropped many of your activities and interests? *

YesNo

Do you feel happy most of the time? *

YesNo

Do you feel pretty worthless the way you are now? *

YesNo

Do you feel that your life is empty? *

YesNo

Do you often feel helpless? *

YesNo

Do you feel full of energy? *

YesNo

Do you often get bored? *

YesNo

Do you prefer to stay at home, rather than going out and doing new things? *

YesNo

Do you feel that your situation is hopeless? *

YesNo

Are you in good spirits most of the time? *

YesNo

Do you feel you have more problems with memory than most people? *

YesNo

Do you think that most people are better off than you are? *

YesNo

Total

References:

Sheikh JI, Yesavage JA. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol. 1986 June;5(1/2):165-173.
Yesavage JA. Geriatric Depression Scale. Psychopharmacol Bull. 1988;24(4):709-711.
Yesavage JA, Brink TL, Rose TL, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res. 1982-83;17(1):37-49.