Self-report measures of anxiety: are they suitable for older adults?

To assess the performance of four self-report measures of anxiety in an older adult population.

Forty older adults with current or previous anxiety symptoms completed four self-report measures of anxiety (Beck Anxiety Inventory, State Trait Anxiety Inventory, Hospital Anxiety and Depression Scale and Visual Analogue Scale) and received an independent diagnostic assessment and rating of anxiety severity. After a minimum of four months, participants were re-assessed on all measures.

The self-report measures most suited for anxiety screening and assessing severity when compared to the independent assessment were the Beck Anxiety Inventory (BAI), the anxiety scale from the Hospital Anxiety and Depression Scale (HADS-A) and State Trait Anxiety Inventory-Trait form (STAI-T). However, participants made an unacceptably high number of errors using the STAI-T, making the BAI and HADS-A the most suitable measures for older adults. The Visual Analogue Scale (VAS) performed poorly in both screening and measuring severity. All self-report measures were poor at detecting change as evaluated by the independent assessment.

There was no single measure that performed adequately in screening, measuring severity and monitoring changes, suggesting that measures may need to be adapted if they are to be used in an older adult population. The lack of appropriately designed self-report measures with adequate normative data for older people presents a barrier to future research.