Psychometric properties of the generalized anxiety disorder Scale (GAD-7) in older adults with advanced cancer Journal Article
| Authors: | Saracino, R. M.; Kehoe, L. A.; Sohn, M. B.; Wang, L.; Mohile, S.; Wells, M.; Mustian, K.; Morrow, G.; Bradley, T.; Onitilo, A.; Giguere, J.; McConnell, K. M. |
| Article Title: | Psychometric properties of the generalized anxiety disorder Scale (GAD-7) in older adults with advanced cancer |
| Abstract: | Objectives: Over half of new cancer diagnoses occur in patients aged 65 or older, with up to 40% experiencing anxiety. The American Society of Clinical Oncology recommends using the Generalized Anxiety Disorder Scale (GAD-7) for anxiety screening, but the GAD-7 psychometric properties in this population are unknown. This study examined the GAD-7's reliability, validity, and item parameters, comparing its utility with the GAD-2 in older adults with cancer. Methods: This cross-sectional secondary analysis of a nationwide multi-site two-arm cluster randomized trial in older adults (≥ 70) with advanced cancer. The GAD-7 was administered at baseline. Properties were evaluated with Cronbach's α, Pearson correlation coefficients, and a 2-parameter logistic model. Logistic regression models compared the GAD-2 and GAD-7. Results: The sample included 718 participants (Mean age = 77, SD = 5) with mild anxiety (M = 3.74, SD = 4.74). Internal consistency was strong (Cronbach's alpha = 0.89) and item-total correlations ranged 0.53 to 0.78. Item 2 (Not being able to stop or control worrying) was the most discriminating and item 5 (Being so restless that it is hard to sit still) was least discriminating. Area Under the Curve (AUC) analyses demonstrated the GAD-2 had a 0.93–0.96 AUC. Conclusions: Establishing the psychometric properties of anxiety screening measures is crucial in the older adults with cancer to maximize referral efficiency and accuracy. This study indicates that the GAD-7 is reliable and valid for older adults with cancer. Analyses suggest the GAD-2 may be as sufficient as the GAD-7 in identifying anxiety in older adults with cancer, thereby reducing assessment burden. © 2024 John Wiley & Sons Ltd. |
| Keywords: | controlled study; aged; aged, 80 and over; major clinical study; clinical trial; advanced cancer; area under the curve; neoplasm; neoplasms; reproducibility; reproducibility of results; randomized controlled trial; psychology; oncology; social support; multicenter study; diagnosis; lymphoma; psychological rating scale; psychiatric status rating scales; anxiety disorder; cognition; aging; cross-sectional study; cross-sectional studies; construct validity; anxiety; anxiety disorders; psychometrics; geriatric assessment; internal consistency; psychometry; generalized anxiety; geriatric oncology; geriatric depression scale; very elderly; cancer; humans; human; male; female; article; likert scale; generalized anxiety disorder-7; generalized anxiety disorder-2 |
| Journal Title: | Psycho-Oncology |
| Volume: | 33 |
| Issue: | 11 |
| ISSN: | 1057-9249 |
| Publisher: | John Wiley & Sons |
| Date Published: | 2024-11-01 |
| Start Page: | e70012 |
| Language: | English |
| DOI: | 10.1002/pon.70012 |
| PUBMED: | 39482282 |
| PROVIDER: | scopus |
| PMCID: | PMC11905212 |
| DOI/URL: | |
| Notes: | Source: Scopus |
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