Effectiveness of a Smart Community- and Home-based Integrated Care Services System for Elderly People in Rural Chinese Communities: A Randomized Controlled Trial in Changsha County
Phase: NA
Conditions: Smart Community- and Home-based Integrated Care Services
Sponsor: Liu Zhihan

1
STUDY PROTOCOL
Effectiveness of a Smart Community- and Home-based Integrated
Care Services System for Elderly People in Rural Chinese
Communities: A Randomized Controlled Trial in Changsha
County
Unique Protocol Number: 234083
Version: V1.0
Date: June 12, 2024
Sponsor: Liu Zhihan
Principal Investigator: Liu Zhihan

2
CONTENTS
1 BACKGROUND..................................................................................................................................................4
2. OBJECTIVE....................................................................................................................................................... 4
3. PARTICIPANT SELECTION AND WITHDRAWAL....................................................................................5
3.1
Inclusion Criteria..................................................................................................................................5
3.2
Exclusion Criteria.................................................................................................................................5
3.3
Withdrawal Criteria..............................................................................................................................5
4.
OVERALL STUDY DESIGN.........................................................................................................................6
4.1
Study Type/Design............................................................................................................................... 6
4.2
Randomization and Blinding................................................................................................................7
4.2.1
Randomization Method.........................................................................................................................7
4.2.2
Blinding................................................................................................................................................ 7
4.3
Study Phases.........................................................................................................................................7
4.3.1
Baseline Survey.................................................................................................................................... 7
4.3.2
Follow-up............................................................................................................................................. 8
5
PARTICIPANT TREATMENT.....................................................................................................................8
5.1
Intervention...........................................................................................................................................8
5.2
Compliance...........................................................................................................................................8
6
EFFICACY EVALUATION...........................................................................................................................8
6.1
Primary Outcome................................................................................................................................. 8
6.2
Secondary Outcome............................................................................................................................. 9
7
SAFETY ASSESSMENT................................................................................................................................9
7.1
Adverse Events.....................................................................................................................................9
8. DATA MANAGEMENT.....................................................................................................................................9
8.1
Source Data, Data Collection Form Filling, and Transfer...................................................................9
8.2
Database Design...................................................................................................................................9
8.3
Data Entry.............................................................................................................................................9
8.4
Data Verification.................................................................................................................................10
9
STUDY MANAGEMENT..............................................................................................................................10
9.1
Declaration......................................................................................................................................... 10
9.2
Ethical Considerations........................................................................................................................10
9.3
Original Records Verification.............................................................................................................10
9.4
Quality Assurance/Monitoring...........................................................................................................10
9.5
Informed Consent...............................................................................................................................10
9.6
Protocol Revision Rules..................................................................................................................... 11
9.7
Monitoring..........................................................................................................................................11
9.8
Confidentiality Agreement and Participant Privacy...........................................................................11
10
PUBLICATION OF RESULTS................................................................................................................... 11
11
ARCHIVING OF RESEARCH DATA....................................................................................................... 11
12
APPENDICES...............................................................................................................................................12
13
REFERENCES..............................................................................................................................................20

3
Protocol Summary
Study Title
Effectiveness of a Smart Community- and Home-based Integrated Care
Services System for Elderly People in Rural Chinese Communities: A
Randomized Controlled Trial in Changsha County
Version
V1.0
Date
Sponso
June 12, 2024
r
Liu Zhihan
Objective
To assess the impact of the smart community home-based integrated care
service system on the health of elderly individuals in rural communities.
Study Design
Randomized Controlled Trial
Total Participants
64
Number of Study
Centers
1
Study Duration
3 years
Inclusion
Criteria:
(1) Age k 60 years
(2) Normal verbal communication ability
(3) No self-reported visual or auditory impairments
(4) A long-term caregiver residing with the participant
(5) Both the participant and their family members have given informed
consent and voluntarily agreed to participate.
Intervention
Organize information sessions to introduce the :Hunan Province Medical
and Elderly Care Smart Service Platform; and encourage elderly individuals
in the experimental group to register and use the platform to receive
integrated care services.
Statistical
Analysis
t-test and ANOVA

4
1
Background
As the aging population grows, elderly health issues have become a key social concern.
Effectively managing the health of elderly individuals and improving their quality of life are
urgent needs in society.In recent years, the widespread application of emerging information
technologies such as artificial intelligence, the Internet of Things, big data, cloud computing,
and 5G has made "smart " a new breakthrough in the integrated healthcare and elderly care
model. Smart Community- and Home-based Integrated Care Services , utilizing methods such
as home hospital beds and mobile medical visits, ensure that key elderly groups with
disabilities, dementia, chronic diseases, advanced age, and disabilities can receive the
necessary medical services at home. This not only allows the elderly to live in familiar home
environments, maintaining their independence and dignity, but also alleviates the pressure on
medical resources, enabling more resources to be allocated to emergency care and highly
specialized nursing. However, the smart healthcare and elderly care platform model is still in
the pilot stage and requires more scientific evidence to verify its actual impact on the health of
the elderly.Conducting a randomized controlled trial (RCT) will provide high-quality
evidence to confirm whether the smart elderly care platform can improve elderly health and to
identify potential issues in the implementation process, which could help refine the existing
model.
2.
Objective
To verify the potential health benefits of the smart elderly care platform. By collecting
health data at multiple time points before and after the intervention, this study aims to
compare the health indicators of elderly individuals who use the platform with those who do
not, thereby providing scientific evidence for the promotion of the platform and its wider
application among elderly populations.

5
3.
Participant Selection and Withdrawal
3.1
Inclusion Criteria
(1) Age k 60 years
(2) Normal verbal communication ability
(3) No self-reported visual or auditory impairments
(4) A long-term caregiver residing with the participant
(5) Both the participant and their family members have given informed consent and
voluntarily agreed to participate
3.2
Exclusion Criteria
(1) Age < 60 years
(2) Severe physical or mental health conditions
(3) Participation in similar studies within the past year
(4) Elderly individuals residing in institutions
3.3
Withdrawal Criteria
Participants may voluntarily withdraw, or the investigator may terminate their
participation in the following cases:
(1) If participants feel they are not benefiting from the study and request withdrawal.
(2) If participants are unable to continue due to circumstances beyond their control.
(3) If the investigator makes protocol adjustments requiring the participant to withdraw.
3.4
Risks and benefits
Elderly participants in this study will have the opportunity to utilize services provided by
the "Hunan Province Intelligent Healthcare Integration Platform," such as in-home nursing,
home care, and home-based medical and elderly care. These services are designed to help the
elderly promptly identify health issues, manage chronic diseases, and prevent the onset of
illnesses, thereby enhancing their overall health. The involvement of participants will aid
researchers in obtaining more reliable data, which will be beneficial for the promotion and
continuous improvement of future smart healthcare models for the elderly.

6
This study aims to improve the health levels of participants and poses no harm to the
individuals involved.
4.
Overall Study Design
4.1
Study Type/Design
This study is a randomized controlled trial (RCT), in which participants who have used
the :Hunan Province Medical and Elderly Care Smart Service Platform; will be assigned to
the experimental group, and those who have not used the platform will be assigned to the
control group. The study will use a blind control method to compare the health indicators of
the two groups to validate the potential improvement of the smart elderly care platform on
elderly health.
(a) Enrollment Phase: The study will recruit participants from Guoyuan Town,
Changsha County. Eligible participants will be selected based on inclusion and exclusion
criteria and undergo a qualification assessment. Considering a 20% loss to follow-up, it is
expected that 64 elderly individuals will be recruited from rural communities in Guoyuan
Town.
(b) Intervention Assignment Phase: Participants will be randomly assigned to the
experimental or control group using computer-generated randomization. Pre-intervention
assessments will be conducted, including measurements of SF-36, Activities of Daily Living
(ADL), Geriatric Depression Scale (GDS). In the intervention phase, elderly individuals in the
experimental group will use the :Hunan Province Medical and Elderly Care Smart Service
Platform; to receive integrated care services, while those in the control group will receive
routine community-based care. Intervention measures will include organizing informational
sessions to introduce the various services of the platform and encouraging the experimental
group to register and use the platform.
(c) Follow-up Phase:Follow-up will occur three times: 3 months, 6 months, and 12
months after the intervention. During follow-up, the same measurements (SF-36, ADL, GDS)
will be taken to assess the health status of participants. Some participants may drop out during
the intervention phase, and the researchers will record the reasons and follow-up data. Data

7
will be collected using dual entry by two different data entry clerks, with regular checks to
ensure accuracy. After the final follow-up, both data files will undergo double-checking for
consistency.
(d) Analysis Phase:Statistical analyses will be conducted using t-tests and ANOVA to
compare primary and secondary outcomes between the experimental and control groups,
verifying the potential health benefits of the smart elderly care platform. Further analysis will
examine influencing factors and underlying mechanisms.
4.2
Randomization and Blinding
4.2.1
Randomization Method
Randomization will be done using a fully computerized system.
A research assistant not involved in the study will use an online randomization program
(http://www.randomization.com/) to generate random sequences. Participants who meet the
inclusion and exclusion criteria will be assigned to either the experimental or control group.
4.2.2
Blinding
In this study, blinding will be used to reduce potential biases and enhance data reliability.
Data collectors will be blinded to the group assignments, ensuring that they are unaware of
whether a participant is in the experimental or control group. This design ensures the
objectivity and independence of the data collection process. Additionally, outcome evaluators
will also be blinded to prevent interference from the intervention during data analysis and
outcome assessment.
4.3
Study Phases
4.3.1
Baseline Survey
A baseline survey will be conducted before the intervention to assess the health status of
the elderly participants. The baseline survey will use standardized questionnaires, including

8
demographic information (e.g., gender, age, marital status, education level), medical history,
SF-36, ADL, and GDS.
4.3.2
Follow-up
Follow-up surveys will be conducted at three-month intervals after the intervention. The
same instruments used in the baseline survey will be applied to ensure consistency and
comparability. The follow-up data will be recorded and analyzed. The final visit will take
place at the end of the study to assess changes in health outcomes throughout the intervention
period and evaluate the effects of the intervention.
5
Participant Treatment
5.1
Intervention
The experimental group will use the :Hunan Province Medical and Elderly Care Smart
Service Platform; to receive integrated care services, while the control group will receive
standard community-based care without using the platform. All intervention measures will be
documented in detail to ensure consistency and control during the entire study period.
5.2
Compliance
Compliance will be assessed based on the participant 9 s registration and use of the
:Hunan Province Medical and Elderly Care Smart Service Platform.; Participants must use
the platform at least once to be considered compliant. The study team will regularly monitor
participant adherence and will take measures to encourage compliance for those with poor
adherence, documenting reasons and corrective actions
6
Efficacy Evaluation
6.1
Primary Outcome
The primary outcome is the overall change in health status, assessed using SF-36. The
comparison will be made between the baseline (T0) and the final visit scores to evaluate the
effect of the intervention on elderly health.

9
6.2
Secondary Outcome
Secondary outcomes include changes in physical and mental health status. Physical
health will be assessed using ADL, and mental health will be assessed using the Geriatric
Depression Scale (GDS). These outcomes will help evaluate the comprehensive impact of the
intervention.
7
Safety Assessment
7.1
Adverse Events
All adverse medical events, regardless of whether they are related to the research
intervention, will be thoroughly documented. Adverse events include symptoms, signs, and
abnormal findings reported by the participants during medical examinations. Safety
monitoring will begin from the participant's enrollment and continue until the conclusion of
the study, ensuring timely identification and management of any potential safety risks. All
adverse events and serious adverse events will be recorded in the safety monitoring report and
regularly submitted to the ethics committee.
8.
Data Management
8.1
Source Data, Data Collection Form Filling, and Transfer
All source data will be accurately recorded in the data collection forms and regularly
transferred to the data management center for compilation and analysis. The data collection
forms will be filled out strictly according to the research protocol to ensure data accuracy and
integrity.
8.2
Database Design
A database framework will be established using SPSS 26.0 software, with pre-entry
debugging for the data.
8.3
Data Entry
The collected data will be entered by two independent data entry clerks, with each clerk

10
saving their data files separately. This dual data entry method ensures that the data is
accurately recorded.
8.4
Data Verification
During data management, data will be verified through logical checks and manual
reviews. Any discrepancies will be electronically recorded in the system, and the research
center will be responsible for resolving the issues until all data is confirmed to be accurate.
This process ensures the accuracy and completeness of the data.
9
Study Management
9.1
Declaration
A statement by the researchers will be issued for this study.
9.2
Ethical Considerations
This study will adhere to international ethical guidelines and comply with relevant
regulations and the review opinions of the ethics committee to ensure the rights and safety of
participants.
9.3
Original Records Verification
All original records and data will be carefully maintained and periodically verified to
ensure the completeness and authenticity of the data.
9.4
Quality Assurance/Monitoring
A systematic quality assurance process will be established to ensure that the study
implementation, data generation, recording, and reporting comply with the study protocol and
relevant regulations. Regular monitoring will be conducted to ensure that all research
activities and documentation are in compliance with the established guidelines.
9.5
Informed Consent
All participants in this study will sign an informed consent form.

11
9.6
Protocol Revision Rules
All revisions to the protocol will be documented as supplementary amendments. Any
changes to the protocol will require approval by the ethics committee.
9.7
Monitoring
The study will be conducted according to the study protocol, standard operating
procedures, and relevant legal requirements, with monitoring by the Ethics Committee of
Central South University.
9.8
Confidentiality Agreement and Participant Privacy
The study will maintain the anonymity of participants. Data collection forms will use
capital letters, numbers, and/or codes to identify participants. Documents that could reveal
participants' identities will be strictly confidential.
10
Publication of Results
The
study
aims
to
publish
1-2
high-quality
papers
in
journals
such
as
SCI/SSCI/CSSCI/CSCD.
11
Archiving of Research Data
The research data will be electronically archived, ensuring security and compliance with
privacy protocols.

 
 
 
 
 
 
  
Please answer the 36 questions of the Health 
SF-36 QUESTIONNAIRE
Name:____________________
Date: _______
Survey completely, honestly, and without interruptions. 
GENERAL HEALTH:
In general, would you say your health is:
 Excellent
Very Good
Good
Fair
Poor
Compared to one year ago, how would you rate your health in general now?
 Much better now than one year ago
Somewhat better now than one year ago
About the same
Somewhat worse now than one year ago
Much worse than one year ago
LIMITATIONS OF ACTIVITIES:
The following items are about activities you might do during a typical day. Does your health now limit you in these
activities? If so, how much?
Vigorous activities, such as running, lifting heavy objects, participating in strenuous sports.
Yes, Limited a lot
Yes, Limited a Little
No, Not Limited at all
Moderate activities, such as moving a table, pushing a vacuum cleaner, bowling, or playing golf
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Lifting or carrying groceries
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Climbing several flights of stairs
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Climbing one flight of stairs
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Bending, kneeling, or stooping
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Walking more than a mile
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Walking several blocks
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
Walking one block
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
12
12  APPENDICES

Bathing or dressing yourself
Yes, Limited a Lot
Yes, Limited a Little
No, Not Limited at all
PHYSICAL HEALTH PROBLEMS:
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as
a result of your physical health?
Cut down the amount of time you spent on work or other activities
Yes
No
Accomplished less than you would like
Yes
No
Were limited in the kind of work or other activities
Yes
No
Had difficulty performing the work or other activities (for example, it took extra effort)
Yes
No
EMOTIONAL HEALTH PROBLEMS:
During the past 4 weeks, have you had any of the following problems with your work or other regular daily activities as
a result of any emotional problems (such as feeling depressed or anxious)? 
Cut down the amount of time you spent on work or other activities
Yes
No
Accomplished less than you would like
Yes
No
Didn't do work or other activities as carefully as usual
Yes
No
SOCIAL ACTIVITIES:
Emotional problems interfered with your normal social activities with family, friends, neighbors, or groups?
Not at all
Slightly
Moderately
Severe
Very Severe
PAIN:
How much bodily pain have you had during the past 4 weeks?
None
Very Mild
Mild
Moderate
Severe
Very Severe
During the past 4 weeks, how much did pain interfere with your normal work (including both work outside the
home and housework)?
Not at all
A little bit
Moderately
Quite a bit
Extremely
13

ENERGY AND EMOTIONS:
These questions are about how you feel and how things have been with you during the last 4 weeks. For each
question, please give the answer that comes closest to the way you have been feeling. 
Did you feel full of pep?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Have you been a very nervous person?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Have you felt so down in the dumps that nothing could cheer you up?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Have you felt calm and peaceful?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Did you have a lot of energy?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
 None of the Time
14

Have you felt downhearted and blue?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Did you feel worn out?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Have you been a happy person?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
Did you feel tired?
All of the time
Most of the time
A good Bit of the Time
Some of the time
A little bit of the time
None of the Time
SOCIAL ACTIVITIES:
During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with
your social activities (like visiting with friends, relatives, etc.)?
All of the time
Most of the time
Some of the time
A little bit of the time
None of the Time
15

GENERAL HEALTH:
How true or false is each of the following statements for you?
I seem to get sick a little easier than other people
Definitely true
Mostly true
Don't know
Mostly false
Definitely false
I am as healthy as anybody I know
Definitely true
Mostly true
Don't know
Mostly false
Definitely false
I expect my health to get worse
Definitely true
Mostly true
Don't know
Mostly false
Definitely false
My health is excellent
Definitely true
Mostly true
Don't know
Mostly false
Definitely false
16

 
 
Barthel Index of Activities of Daily Living 
 
 
Instructions: Choose the scoring point for the statement that most closely corresponds to the patient's current 
level of ability for each of the following 10 items. Record actual, not potential, functioning. Information can be 
obtained from the patient's self-report, from a separate party who is familiar with the patient's abilities (such as a 
relative), or from observation. Refer to the Guidelines section on the following page for detailed information on 
scoring and interpretation. 
 
The Barthel Index 
 
Bowels 
0 = incontinent (or needs to be given enemata) 
1 = occasional accident (once/week) 
2 = continent 
Patient's Score:  
 
 
 
Bladder 
0 = incontinent, or catheterized and unable to manage 
1 = occasional accident (max. once per 24 hours) 
2 = continent (for over 7 days) 
Patient's Score:  
 
 
 
Grooming 
0 = needs help with personal care 
1 = independent face/hair/teeth/shaving (implements 
provided) 
Patient's Score:  
 
 
 
Toilet use 
0 = dependent 
1 = needs some help, but can do something alone 
2 = independent (on and off, dressing, wiping) 
Patient's Score:  
 
 
 
Feeding 
0 = unable 
1 = needs help cutting, spreading butter, etc. 
2 = independent (food provided within reach) 
Patient's Score:  
 
 
 
 
 
Transfer 
0 = unable – no sitting balance 
1 = major help (one or two people, physical), can sit 
2 = minor help (verbal or physical) 
3 = independent 
Patient's Score:  
 
 
 
Mobility 
0 = immobile 
1 = wheelchair independent, including corners, etc. 
2 = walks with help of one person (verbal or physical) 
3 = independent (but may use any aid, e.g., stick) 
Patient's Score:  
 
 
 
Dressing 
0 = dependent 
1 = needs help, but can do about half unaided 
2 = independent (including buttons, zips, laces, etc.) 
Patient's Score:  
 
 
 
Stairs 
0 = unable 
1 = needs help (verbal, physical, carrying aid) 
2 = independent up and down 
Patient's Score:  
 
 
 
Bathing 
0 = dependent 
1 = independent (or in shower) 
Patient's Score:  
 
 
 
Total Score:  
 
 
(Collin et al., 1988) 
 
 
Scoring: 
Sum the patient's scores for each item. Total possible scores range from 0 – 20, with lower scores indicating 
increased disability. If used to measure improvement after rehabilitation, changes of more than two points in the 
total score reflect a probable genuine change, and change on one item from fully dependent to independent is also 
likely to be reliable. 
 
Sources: 
• 
Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: a reliability study. Int Disabil Stud. 1988;10(2):61-63. 
• 
Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J. 1965;14:61-65. 
• 
Wade DT, Collin C. The Barthel ADL Index: a standard measure of physical disability? Int Disabil Stud. 1988;10(2):64-67. 
17

 
 
Guidelines for the Barthel Index of Activities of Daily Living 
General 
• 
The Index should be used as a record of what a patient does, NOT as a record of what a patient could do.  
• 
The main aim is to establish degree of independence from any help, physical or verbal, however minor and for 
whatever reason. 
• 
The need for supervision renders the patient not independent. 
• 
A patient's performance should be established using the best available evidence. Asking the patient, 
friends/relatives, and nurses will be the usual source, but direct observation and common sense are also 
important. However, direct testing is not needed. 
• 
Usually the performance over the preceding 24 – 48 hours is important, but occasionally longer periods will be 
relevant. 
• 
Unconscious patients should score '0' throughout, even if not yet incontinent. 
• 
Middle categories imply that the patient supplies over 50% of the effort. 
• 
Use of aids to be independent is allowed. 
Bowels (preceding week) 
• 
If needs enema from nurse, then 'incontinent.' 
• 
'Occasional' = once a week. 
Bladder (preceding week) 
• 
'Occasional' = less than once a day. 
• 
A catheterized patient who can completely manage the catheter alone is registered as 'continent.' 
Grooming (preceding 24 – 48 hours) 
• 
Refers to personal hygiene: doing teeth, fitting false teeth, doing hair, shaving, washing face. Implements can 
be provided by helper. 
Toilet use 
• 
Should be able to reach toilet/commode, undress sufficiently, clean self, dress, and leave. 
• 
'With help' = can wipe self and do some other of above. 
Feeding 
• 
Able to eat any normal food (not only soft food). Food cooked and served by others, but not cut up. 
• 
'Help' = food cut up, patient feeds self. 
Transfer 
• 
From bed to chair and back. 
• 
'Dependent' = NO sitting balance (unable to sit); two people to lift. 
• 
'Major help' = one strong/skilled, or two normal people. Can sit up. 
• 
'Minor help' = one person easily, OR needs any supervision for safety. 
Mobility 
• 
Refers to mobility about house or ward, indoors. May use aid. If in wheelchair, must negotiate corners/doors 
unaided. 
• 
'Help' = by one untrained person, including supervision/moral support. 
Dressing 
• 
Should be able to select and put on all clothes, which may be adapted. 
• 
'Half' = help with buttons, zips, etc. (check!), but can put on some garments alone. 
Stairs 
• 
Must carry any walking aid used to be independent. 
Bathing 
• 
Usually the most difficult activity. 
• 
Must get in and out unsupervised, and wash self. 
• 
Independent in shower = 'independent' if unsupervised/unaided. 
 
(Collin et al., 1988) 
18

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
  
 
  
 
  
 
 
 
  
 
 
 
  
 
  
 
  
 
 
 
  
 
 
 
  
 
  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Geriatric Depression Scale (Short Form)  
 
Date:  
Choose the best answer for how you felt over the past week. 
              Name: 
Instructions: 
Note: when asking the 
patient to complete the form, provide the self-rated form (included on the following page). 
No. Question 
Answer 
Score 
1. 
Are you basically satisfied with your life? 
YES / NO 
2. 
Have you dropped many of your activities and interests? 
YES / NO 
3. 
Do you feel that your life is empty? 
YES / NO 
4. 
Do you often get bored? 
YES / NO 
5. 
Are you in good spirits most of the time? 
YES / NO 
6. 
Are you afraid that something bad is going to happen to you? 
YES / NO 
7. 
Do you feel happy most of the time? 
YES / NO 
8. 
Do you often feel helpless? 
YES / NO 
9. 
Do you prefer to stay at home, rather than going out and doing new things? YES / NO 
10. 
Do you feel you have more problems with memory than most people? 
YES / NO 
11. 
Do you think it is wonderful to be alive? 
YES / NO 
12. 
Do you feel pretty worthless the way you are now? 
YES / NO 
13. 
Do you feel full of energy? 
YES / NO 
14. 
Do you feel that your situation is hopeless? 
YES / NO 
15. 
Do you think that most people are better off than you are? 
YES / NO 
TOTAL 
(Sheikh & Yesavage, 1986) 
Scoring: 
Answers indicating depression are in bold and italicized; score one point for each one selected. A score of 0 to 5 
is normal. A score greater than 5 suggests depression. 
Sources: 
"  
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. 
19

13
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