Agreement between Patient and Proxy Assessments of Quality of Life among Older Adults with Vascular Cognitive Impairment Using the EQ-5D-3L and ICECAP-O

Jennifer C Davis, Ging-Yuek Hsiung, Stirling Bryan, Claudia Jacova, Patrizio Jacova, Michelle Munkacsy, Winnie Cheung, Philip Lee, Teresa Liu-Ambrose, Jennifer C Davis, Ging-Yuek Hsiung, Stirling Bryan, Claudia Jacova, Patrizio Jacova, Michelle Munkacsy, Winnie Cheung, Philip Lee, Teresa Liu-Ambrose

Abstract

Background: The assessment of quality of life is critical in ascertaining the benefit of interventions aimed to reduce morbidity among individuals with cognitive impairment. However, the assessment of quality of life is challenging in this population due to the uncertain validity of patient responses as cognitive function declines. Hence, we examined the level of agreement between patient and proxy assessments of health related quality of life (HRQoL) and wellbeing based on the domains that comprise each of these constructs.

Methods: Analysis of baseline data from 71 community-dwelling older adults with mild Vascular Cognitive Impairment (VCI) who participated in a six-month proof-of-concept single-blinded randomized trial. Level of agreement between patient and caregiver ratings of HRQoL (EQ-5D-3L) and wellbeing (ICECAP-O) were compared using raw agreement (%), intraclass correlation coefficient (ICC) and weighted Cohen's kappa statistic.

Results: Self-care (assessed via the EQ-5D-3L) demonstrated almost perfect raw agreement between the patient and caregiver ratings. Three domains (mobility, pain and anxiety) of the EQ-5D-3L demonstrated fair agreement between the patient and caregiver ratings. Two (attachment and control) of the five ICECAP-O domains demonstrated slight agreement. The ICC indicated good agreement for the EQ-5D-3L and poor agreement for the ICECAP-O.

Conclusion: There is better patient-proxy agreement for the EQ-5D-3L compared with the ICECAP-O among individuals with mild VCI. These findings imply that the ICECAP-O may have limited clinical, research and policy related utility among individuals with mild VCI.

Trial registration: ClinicalTrials.gov NCT01027858.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Roman GC (2002) Vascular dementia may be the most common form of dementia in the elderly. J Neurol Sci 203–204: 7–10.
    1. Rockwood K, Wentzel C, Hachinski V, Hogan DB, MacKnight C, McDowell I (2000) Prevalence and outcomes of vascular cognitive impairment. Vascular Cognitive Impairment Investigators of the Canadian Study of Health and Aging. Neurology 54: 447–451.
    1. Desmond DW, Erkinjuntti T, Sano M, Cummings JL, Bowler JV, Pasquier F, et al. (1999) The cognitive syndrome of vascular dementia: implications for clinical trials. Alzheimer Dis Assoc Disord 13 Suppl 3: S21–29.
    1. Erkinjuntti T, Bowler JV, DeCarli CS, Fazekas F, Inzitari D, O'Brien JT, et al. (1999) Imaging of static brain lesions in vascular dementia: implications for clinical trials. Alzheimer Dis Assoc Disord 13 Suppl 3: S81–90.
    1. Pantoni L, Leys D, Fazekas F, Longstreth WT Jr, Inzitari D, Wallin A, et al. (1999) Role of white matter lesions in cognitive impairment of vascular origin. Alzheimer Dis Assoc Disord 13 Suppl 3: S49–54.
    1. Pusswald G, Tropper E, Kryspin-Exner I, Moser D, Klug S, Auff E, et al. (2015) Health-Related Quality of Life in Patients with Subjective Cognitive Decline and Mild Cognitive Impairment and its Relation to Activities of Daily Living. J Alzheimers Dis 47: 479–486. 10.3233/JAD-150284
    1. Bryan S, Hardyman W, Bentham P, Buckley A, Laight A (2005) Proxy completion of EQ-5D in patients with dementia. Qual Life Res 14: 107–118.
    1. Jonsson L, Andreasen N, Kilander L, Soininen H, Waldemar G, Nygaard H, et al. (2006) Patient- and proxy-reported utility in Alzheimer disease using the EuroQoL. Alzheimer Dis Assoc Disord 20: 49–55.
    1. McPhail S, Beller E, Haines T (2008) Two perspectives of proxy reporting of health-related quality of life using the Euroqol-5D, an investigation of agreement. Med Care 46: 1140–1148. 10.1097/MLR.0b013e31817d69a6
    1. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De Vugt M, et al. (2008) A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 12: 14–29. 10.1080/13607860801919850
    1. Brazier J, Ratcliffe J, Salomon JA, Tsuchiya A (2007) Measuring and Valuing Health Benefits for Economic Evaluation. Oxford: Oxford University Press.
    1. Liu-Ambrose T, Nagamatsu LS, Graf P, Beattie BL, Ashe MC, Handy TC (2010) Resistance training and executive functions: a 12-month randomized controlled trial. Arch Intern Med 170: 170–178. 10.1001/archinternmed.2009.494
    1. Moniz-Cook E, Vernooij-Dassen M, Woods R, Verhey F, Chattat R, De Vugt M, et al. (2008) A European consensus on outcome measures for psychosocial intervention research in dementia care. Aging Ment Health 12: 14–29. 10.1080/13607860801919850
    1. Rabins PV, Black BS (2007) Measuring quality of life in dementia: purposes, goals, challenges and progress. Int Psychogeriatr 19: 401–407.
    1. Flynn TN, Chan P, Coast J, Peters TJ (2011) Assessing quality of life among British older people using the ICEPOP CAPability (ICECAP-O) measure. Appl Health Econ Health Policy 9: 317–329. 10.2165/11594150-000000000-00000
    1. Mitchell PM, Roberts TE, Barton PM, Coast J (2015) Assessing sufficient capability: A new approach to economic evaluation. Soc Sci Med 139: 71–79. 10.1016/j.socscimed.2015.06.037
    1. Sen A, Nussbaum M (1993) Capability and well-being Oxford: Oxford University Press.
    1. Coast J, Flynn TN, Natarajan L, Sproston K, Lewis J, Louviere JJ, et al. (2008) Valuing the ICECAP capability index for older people. Soc Sci Med 67: 874–882. 10.1016/j.socscimed.2008.05.015
    1. Rowen D, Brazier J, Tsuchiya A, Alava MH (2011) Valuing states from multiple measures on the same visual analogue sale: a feasibility study. Health Econ.
    1. Marra CA, Esdaile JM, Guh D, Kopec JA, Brazier JE, Koehler BE, et al. (2004) A comparison of four indirect methods of assessing utility values in rheumatoid arthritis. Med Care 42: 1125–1131.
    1. Vogel A, Mortensen EL, Hasselbalch SG, Andersen BB, Waldemar G (2006) Patient versus informant reported quality of life in the earliest phases of Alzheimer's disease. Int J Geriatr Psychiatry 21: 1132–1138.
    1. Ready RE, Ott BR, Grace J (2004) Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer's disease. Int J Geriatr Psychiatry 19: 256–265.
    1. Makai P, Looman W, Adang E, Melis R, Stolk E, Fabbricotti I (2014) Cost-effectiveness of integrated care in frail elderly using the ICECAP-O and EQ-5D: does choice of instrument matter? Eur J Health Econ.
    1. Makai P, Beckebans F, van Exel J, Brouwer WB (2014) Quality of life of nursing home residents with dementia: validation of the German version of the ICECAP-O. PLoS One 9: e92016 10.1371/journal.pone.0092016
    1. Makai P, Brouwer WB, Koopmanschap MA, Nieboer AP (2012) Capabilities and quality of life in Dutch psycho-geriatric nursing homes: an exploratory study using a proxy version of the ICECAP-O. Qual Life Res 21: 801–812. 10.1007/s11136-011-9997-1
    1. Liu-Ambrose T, Eng JJ, Boyd LA, Jacova C, Davis JC, Bryan S, et al. (2010) Promotion of the mind through exercise (PROMoTE): a proof-of-concept randomized controlled trial of aerobic exercise training in older adults with vascular cognitive impairment. BMC Neurol 10: 14 10.1186/1471-2377-10-14
    1. Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, et al. (2000) Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm Suppl 59: 23–30.
    1. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society 53: 695–699.
    1. Dolan P (1997) Modeling valuations for EuroQol health states. Med Care 35: 1095–1108.
    1. Bansback N, Tsuchiya A, Brazier J, Anis A (2012) Canadian valuation of EQ-5D health states: preliminary value set and considerations for future valuation studies. PLOS ONE 7: e31115 10.1371/journal.pone.0031115
    1. Coast J, Al-Janabi H (2008) .
    1. Coast J, Peters TJ, Natarajan L, Sproston K, Flynn T (2008) An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people. Qual Life Res 17: 967–976. 10.1007/s11136-008-9372-z
    1. Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J (1994) The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 44: 2308–2314.
    1. Lord S, Sherrington C, Menz H (2001) A physiological profile approach for falls prevention Falls in older people Risk factors and strategies for prevention. Cambridge: Cambridge University Press; pp. 221–238.
    1. Lord SR, Sherrington C, Menz H (2001) A Physiological Profile Approach for Falls Prevention Falls in Older People. Risk Factors and Strategies for Prevention. Cambridge: Cambridge University Press.
    1. Lord SR, Ward JA, Williams P, Anstey KJ (1994) Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc 42: 1110–1117.
    1. Lord S, Clark R, Webster I (1991) Physiological factors associated with falls in an elderly population. Journal of American Geriatrics Society 39: 1194–1200.
    1. Lord S, Ward J, Williams P, Anstey K (1994) Physiological factors associated with falls in older community-dwelling women. Journal of American Geriatrics Society 42: 1110–1117.
    1. Delbaere K, Close JCT, Brodaty H, Sachdev P, Lord SR (2010) Determinants of disparities between perceived and physiological risk o falling among elderly people: cohort study. British Medical Journal.
    1. Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189–198.
    1. Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, et al. (2005) The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 53: 695–699.
    1. Rosen WG, Mohs RC, Davis KL (1984) A new rating scale for Alzheimer's disease. Am J Psychiatry 141: 1356–1364.
    1. Ylikoski R, Jokinen H, Andersen P, Salonen O, Madureira S, Ferro J, et al. (2007) Comparison of the Alzheimer's Disease Assessment Scale Cognitive Subscale and the Vascular Dementia Assessment Scale in differentiating elderly individuals with different degrees of white matter changes. The LADIS Study. Dement Geriatr Cogn Disord 24: 73–81.
    1. Farlow M, Lane R, Kudaravalli S, He Y (2004) Differential qualitative responses to rivastigmine in APOE epsilon 4 carriers and noncarriers. Pharmacogenomics J 4: 332–335.
    1. Kemp PM, Holmes C, Hoffmann S, Wilkinson S, Zivanovic M, Thom J, et al. (2003) A randomised placebo controlled study to assess the effects of cholinergic treatment on muscarinic receptors in Alzheimer's disease. J Neurol Neurosurg Psychiatry 74: 1567–1570.
    1. Orgogozo JM, Rigaud AS, Stoffler A, Mobius HJ, Forette F (2002) Efficacy and safety of memantine in patients with mild to moderate vascular dementia: a randomized, placebo-controlled trial (MMM 300). Stroke 33: 1834–1839.
    1. Wilkinson D, Doody R, Helme R, Taubman K, Mintzer J, Kertesz A, et al. (2003) Donepezil in vascular dementia: a randomized, placebo-controlled study. Neurology 61: 479–486.
    1. Jia JJ. The effects of DL-3-n-butylphthalide in patients with vascular cognitive impairment without dementia caused by subcortical ischemic small vessel disease: A multicentre, randomized, double-blind, placebo-controlled trial. Alzheimer's & dementia.
    1. Salloway S, Ferris S, Kluger A, Goldman R, Griesing T, Kumar D, et al. (2004) Efficacy of donepezil in mild cognitive impairment: a randomized placebo-controlled trial. Neurology 63: 651–657.
    1. Feinstein AR, Cicchetti DV (1990) High agreement but low kappa: I. The problems of two paradoxes. J Clin Epidemiol 43: 543–549.
    1. Davis JC, Liu-Ambrose T, Richardson CG, Bryan S (2012) A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: are they complements or substitutes? Qual Life Res.

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