Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments

Jennifer C Davis, Stirling Bryan, Rob McLeod, Jessica Rogers, Karim Khan, Teresa Liu-Ambrose, Jennifer C Davis, Stirling Bryan, Rob McLeod, Jessica Rogers, Karim Khan, Teresa Liu-Ambrose

Abstract

Background: Our research sought to understand how falls risk, cognitive function, and daily function are associated with health related quality of life (using the EuroQol-5D) and quality of life (using the ICECAP-O) among older adults with mobility impairments.

Methods: The EQ-5D and ICECAP-O were administered at 12 months post first clinic attendance at the Vancouver Falls Prevention Clinic. We report descriptive statistics for all baseline characteristics collected at first clinic visit and primary outcomes of interest. Using multivariate stepwise linear regression, we assessed the construct validity of the EQ-5D and ICECAP-O using three dependent measures that are recognized indicators of "impaired mobility" - physiological falls risk, general balance and mobility, and cognitive status among older adults.

Results: We report data on 215 seniors who attended the Vancouver Falls Prevention Clinic and received their first clinic assessment. Patients had a mean age of 79.3 (6.2) years. After accounting for known covariates (i.e., age and sex), the ICECAP-O domains explained a greater amount of variation in each of the three dependent measures compared with the EQ-5D domains.

Conclusion: Both the EQ-5D and ICECAP-O demonstrate associations with falls risk and general balance and mobility; however, only the ICECAP-O was associated with cognitive status among older adults with mobility impairments.

Trial registration: ClinicalTrials.gov Identifier: NCT01022866.

References

    1. Kirchengast S, Haslinger B. Gender differences in health-related quality of life among healthy aged and old-aged Austrians: cross-sectional analysis. Gend Med. 2008;5(3):270–278. doi: 10.1016/j.genm.2008.07.001.
    1. Liu-Ambrose T, Khan KM, Donaldson MG, Eng JJ, Lord SR, McKay HA. Falls-related self-efficacy is independently associated with balance and mobility in older women with low bone mass. J Gerontol A Biol Sci Med Sci. 2006;61(8):832–838. doi: 10.1093/gerona/61.8.832.
    1. Fagerstrom C, Borglin G. Mobility, functional ability and health-related quality of life among people of 60 years or older. Aging Clin Exp Res. 2010;22(5–6):387–394.
    1. Davis JC, Marra CA, Najafzadeh M, Liu-Ambrose T. The independent contribution of executive functions to health related quality of life in older women. BMC Geriatr. 2010;10:16. doi: 10.1186/1471-2318-10-16.
    1. Davis JC, Marra CA, Liu-Ambrose TY. Falls-related self-efficacy is independently associated with quality-adjusted life years in older women. Age Ageing. 2011;40(3):340–346. doi: 10.1093/ageing/afr019.
    1. Heydarnejad S, Dehkordi AH. The effect of an exercise program on the health-quality of life in older adults. A randomized controlled trial. Dan Med Bull. 2010;57(1):A4113.
    1. Gill TM, Baker DI, Gottschalk M, Peduzzi PN, Allore H, Byers A. A program to prevent functional decline in physically frail, elderly persons who live at home. N Engl J Med. 2002;347(14):1068–1074. doi: 10.1056/NEJMoa020423.
    1. Fielding RA, Rejeski WJ, Blair S, Church T, Espeland MA, Gill TM, Guralnik JM, Hsu FC, Katula J, King AC. et al.The Lifestyle Interventions and Independence for Elders Study: Design and Methods. J Gerontol A Biol Sci Med Sci. 2011;66A(11):1226–1237. doi: 10.1093/gerona/glr123.
    1. Flynn TN, Chan P, Coast J, Peters TJ. Assessing Quality of Life among British Older People Using the ICEPOP CAPability (ICECAP-O) Measure. Appl Health Econ Health Policy. 2011;9(5):317–329. doi: 10.2165/11594150-000000000-00000.
    1. Langlois F, Vu TT, Kergoat MJ, Chasse K, Dupuis G, Bherer L. The multiple dimensions of frailty: physical capacity, cognition, and quality of life. Int Psychogeriatr. 2012;24(9):1–8.
    1. Coast J, Flynn TN, Natarajan L, Sproston K, Lewis J, Louviere JJ, Peters TJ. Valuing the ICECAP capability index for older people. Soc Sci Med. 2008;67(5):874–882. doi: 10.1016/j.socscimed.2008.05.015.
    1. Dolan P. Modeling valuations for EuroQol health states. Med Care. 1997;35(11):1095–1108. doi: 10.1097/00005650-199711000-00002.
    1. Brazier J, Roberts J, Tsuchiya A, Busschbach J. A comparison of the EQ-5D and SF-6D across seven patient groups. Health Econ. 2004;13(9):873–884. doi: 10.1002/hec.866.
    1. Marra CA, Woolcott JC, Kopec JA, Shojania K, Offer R, Brazier JE, Esdaile JM, Anis AH. A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis. Soc Sci Med. 2005;60(7):1571–1582. doi: 10.1016/j.socscimed.2004.08.034.
    1. Coast J, Peters TJ, Natarajan L, Sproston K, Flynn T. An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people. Qual Life Res. 2008;17(7):967–976. doi: 10.1007/s11136-008-9372-z.
    1. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198. doi: 10.1016/0022-3956(75)90026-6.
    1. Lord S, Sherrington C, Menz H. Falls in older people Risk factors and strategies for prevention. Cambridge: Cambridge University Press; 2001. A physiological profile approach for falls prevention; pp. 221–238.
    1. Lord SR, Clark RD, Webster IW. Physiological factors associated with falls in an elderly population. J Am Geriatr Soc. 1991;39(12):1194–1200.
    1. Lord SR, Menz HB, Tiedemann A. A physiological profile approach to falls risk assessment and prevention. Phys Ther. 2003;83(3):237–252.
    1. Lord SR, Ward JA, Williams P, Anstey KJ. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42(10):1110–1117.
    1. Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB. Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability 10.1056/NEJM199503023320902. N Engl J Med. 1995;332(9):556–562. doi: 10.1056/NEJM199503023320902.
    1. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–186. doi: 10.1093/geront/9.3_Part_1.179.
    1. Rowen D, Brazier J, Tsuchiya A, Alava MH. Valuing states from multiple measures on the same visual analogue sale: a feasibility study. Health Econ. 2011;21(6):715–729.
    1. Brazier J, Roberts J, Deverill M. The estimation of a preference-based measure of health from the SF-36. J Health Econ. 2002;21(2):271–292. doi: 10.1016/S0167-6296(01)00130-8.
    1. Feeny D, Furlong W, Torrance GW, Goldsmith CH, Zhu Z, DePauw S, Denton M, Boyle M. Multiattribute and single-attribute utility functions for the health utilities index mark 3 system. Med Care. 2002;40(2):113–128. doi: 10.1097/00005650-200202000-00006.
    1. Barton GR, Sach TH, Avery AJ, Jenkinson C, Doherty M, Whynes DK, Muir KR. A comparison of the performance of the EQ-5D and SF-6D for individuals aged >or= 45 years. Health Econ. 2008;17(7):815–832. doi: 10.1002/hec.1298.
    1. Luo N, Johnson JA, Shaw JW, Feeny D, Coons SJ. Self-reported health status of the general adult U.S. population as assessed by the EQ-5D and Health Utilities Index. Med Care. 2005;43(11):1078–1086. doi: 10.1097/01.mlr.0000182493.57090.c1.
    1. Campbell AJ, Borrie MJ, Spears GF. Risk factors for falls in a community-based prospective study of people 70 years and older. J Gerontol. 1989;44(4):M112–117. doi: 10.1093/geronj/44.4.M112.
    1. O’Loughlin JL, Robitaille Y, Boivin JF, Suissa S. Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly. Am J Epidemiol. 1993;137(3):342–354.
    1. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med. 1988;319(26):1701–1707. doi: 10.1056/NEJM198812293192604.

Source: PubMed

Sponsors et collaborateurs

Les conditions médicales

Interventions en matière de drogue

3
S'abonner