Purpose: To compare three published short GDS scales and to identify a valid and reliable short-form alternative to the 15-item Geriatric Depression Scale. Design: Comparative validation study via retrospective chart review of 816 acute care patients in an 830-bed academic medical center in the USA in 2001. Methods: Data of the 15-item Geriatric Depression Scale, the Mini-Mental State Examination, and demographic data were extracted from medical records after patient discharge. Three scales: the D'Ath GDS-4, van Marwijk GDS-4, and Hoyl GDS-5, were compared to the 15-item Geriatric Depression Scale. Results: The Hoyl 5-item version showed the highest sensitivity (97.9%). Concern for GDS-5 false positives when compared to the 15-item GDS (specificity 72.7%) led to re-ordering the 15 GDS items into a new two-tiered instrument, the GDS-5/15. In this study of 816 older adult inpatients, 60% were screened as "not depressed" using the first 5 items on the GDS-5/15, leaving 40% for continued screening and completion of all 15 GDS items. Conclusions: A shorter screening tool might encourage more providers to add depression screening to routine health care visits. The GDS-5/15 is an alternative screening tool.