Your GDS-15 Score in Plain Language
The Geriatric Depression Scale short form (GDS-15) is one of the most widely used depression screening tools for older adults. Fifteen yes/no questions, no confusing scales, and it was specifically designed to avoid the physical symptom overlap that makes other depression questionnaires unreliable in elderly populations.
You’ve got a number between 0 and 15. Here’s what it means.
GDS-15 Score Ranges
- 0–4: Normal. Your responses don’t suggest clinically significant depression. This is the range where most non-depressed older adults fall. Scoring in this range doesn’t mean you never feel sad or lonely, but your overall pattern doesn’t meet the threshold for clinical concern.
- 5–8: Mild depression. Your score suggests mild depressive symptoms. This is the range where intervention can make the biggest difference — catching depression before it deepens. Your doctor might recommend lifestyle changes, increased social engagement, and follow-up screening in 4–6 weeks.
- 9–11: Moderate depression. This score indicates a likely depressive episode that warrants active treatment. A combination of psychotherapy and possibly medication is typically recommended. Don’t wait for symptoms to worsen.
- 12–15: Severe depression. A score this high strongly suggests significant depression that requires prompt clinical attention. Treatment should include both medication and therapy, and a thorough safety assessment for suicidal ideation.
Why the GDS Works Better Than Other Tools for Older Adults
Most depression questionnaires (like the PHQ-9 or BDI) include questions about physical symptoms: fatigue, appetite changes, sleep problems, and concentration difficulties. The problem? These symptoms are extremely common in healthy older adults due to medical conditions, medications, and normal aging processes. An 80-year-old with arthritis, on three medications, might endorse half the physical symptom items on the PHQ-9 without having any depression at all.
The GDS-15 cleverly avoids this trap. Its questions focus on emotional and cognitive aspects of depression: life satisfaction, hopelessness, boredom, helplessness, feeling worthless, preferring to stay home, and feeling that others are better off. These psychological markers are more specific to depression in older adults.
What Individual Questions Reveal
While the total score matters most, certain individual items deserve special attention:
- “Do you feel that your life is empty?” — A yes answer here is strongly associated with significant depression and warrants follow-up regardless of total score.
- “Do you feel helpless?” — Helplessness is a core cognitive feature of depression and a risk factor for treatment resistance if not addressed.
- “Do you feel pretty worthless the way you are now?” — Feelings of worthlessness in elderly adults often connect to loss of roles, independence, and purpose. Therapy that specifically addresses identity and meaning is often helpful here.
- “Do you prefer to stay at home rather than going out?” — Social withdrawal is both a symptom and a perpetuating factor. Breaking this cycle is one of the most impactful interventions.
Limitations to Keep in Mind
The GDS-15 is a screening tool, not a diagnostic instrument. A few things it can’t do:
- It doesn’t assess suicidal ideation directly. If there’s any concern about self-harm, a dedicated suicide risk screening like the C-SSRS is needed.
- It loses accuracy in moderate to severe cognitive impairment (MMSE scores below 15). For people with significant dementia, observational scales like the Cornell Scale are more appropriate.
- It may miss atypical depression presentations — some older adults with depression primarily express irritability, anxiety, or agitation rather than the sadness and withdrawal the GDS asks about.
What Happens After a Positive Screen
A GDS score of 5 or above should trigger a comprehensive clinical assessment including medical evaluation (thyroid function, medication review, vitamin B12/folate), clinical interview exploring symptom history and duration, safety assessment, and discussion of treatment options. Early intervention produces the best outcomes.
Frequently Asked Questions
How often should the GDS be administered?
Major geriatric guidelines recommend annual screening for all adults over 65. During active treatment, retesting every 4–6 weeks helps track response. A clinically meaningful change is a reduction of 2 or more points.
Can someone with dementia take the GDS-15?
In mild to moderate cognitive impairment (MMSE 15+), the GDS-15 remains reasonably valid. Below that threshold, comprehension of the questions becomes unreliable and observational measures should be used instead. The simple yes/no format is one reason the GDS works better than more complex tools in mildly impaired older adults.
My parent scored 6 but says they’re fine. What do I do?
A score of 6 puts them in the mild depression range. Older adults often minimize emotional symptoms due to generational attitudes about mental health. Gently share that the screening suggests some concern, frame it as a medical issue (not a character flaw), and suggest discussing it with their doctor. Our article on signs of depression in elderly parents has specific conversation strategies.
