Instructions: Circle the answer that best describes how you felt
over the past week.
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 things? yes no
10. Do you feel that you have more problems with
memory than most? yes no
11. Do you think it is wonderful to be alive now? yes no
12. Do you feel 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
Instructions: Score 1 point for each bolded answer. A score of 5 or more
suggests depression.
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 things? yes no
10. Do you feel that you have more problems with
memory than most? yes no
11. Do you think it is wonderful to be alive now? yes no
12. Do you feel 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
A score of > 5 suggests depression Total Score
Ref. Yes average: The use of Rating Depression Series in the Elderly, in Poon (ed.): Clinical
Memory Assessment of Older Adults, American Psychological Association, 1986
over the past week.
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 things? yes no
10. Do you feel that you have more problems with
memory than most? yes no
11. Do you think it is wonderful to be alive now? yes no
12. Do you feel 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
Instructions: Score 1 point for each bolded answer. A score of 5 or more
suggests depression.
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 things? yes no
10. Do you feel that you have more problems with
memory than most? yes no
11. Do you think it is wonderful to be alive now? yes no
12. Do you feel 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
A score of > 5 suggests depression Total Score
Ref. Yes average: The use of Rating Depression Series in the Elderly, in Poon (ed.): Clinical
Memory Assessment of Older Adults, American Psychological Association, 1986