Quality of Life Research

, Volume 15, Issue 4, pp 631–643

Utility-based Quality of Life Measures in Alzheimer’s Disease

Authors

    • Division of General Internal Medicine and Clinical EpidemiologyUniversity Health Network
    • Geriatrics ProgramToronto Rehabilitation Institute
    • Clinical Epidemiology and Health Care Research ProgramUniversity of Toronto
    • Department of MedicineUniversity of Toronto
    • Department of Health Policy, Management and EvaluationUniversity of Toronto
  • George Tomlinson
    • Clinical Epidemiology and Health Care Research ProgramUniversity of Toronto
    • Department of MedicineUniversity Health Network
    • Department of Public Health SciencesUniversity of Toronto
  • Catherine Tansey
    • Department of MedicineUniversity Health Network
    • Institute of Medical ScienceUniversity of Toronto
  • Jane Irvine
    • Department of PsychologyYork University
    • Department of PsychiatryUniversity of Toronto
  • Paul Ritvo
    • Department of PsychologyYork University
    • Cancer Care Ontario
    • Ontario Cancer Institute
  • Sandra E. Black
    • Department of MedicineUniversity of Toronto
    • Division of NeurologySunnybrook and Women’s College Health Sciences Centre
  • Morris Freedman
    • Department of MedicineUniversity of Toronto
    • Division of NeurologyMount Sinai Hospital
    • Behavioural Neurology Program and Rotman Research InstituteBaycrest Centre for Geriatric Care
    • Division of NeurologyUniversity Health Network
  • Michel Silberfeld
    • Department of PsychiatryUniversity of Toronto
  • Murray Krahn
    • Division of General Internal Medicine and Clinical EpidemiologyUniversity Health Network
    • Clinical Epidemiology and Health Care Research ProgramUniversity of Toronto
    • Department of MedicineUniversity of Toronto
    • Department of Health Policy, Management and EvaluationUniversity of Toronto
Article

DOI: 10.1007/s11136-005-4364-8

Cite this article as:
Naglie, G., Tomlinson, G., Tansey, C. et al. Qual Life Res (2006) 15: 631. doi:10.1007/s11136-005-4364-8

Abstract

Objectives: To explore whether Alzheimer’s disease patients could rate their quality of life (QOL) using utility-based health indexes, and to provide new knowledge about the measurement properties of these instruments for patient and caregiver proxy ratings. Methods: A convenience sample of 60 mild-moderate AD patients and their caregivers were randomized to complete the Quality of Well-Being Scale (QWB), Health Utilities Index (HUI3) or EQ-5D and visual analogue scale (VAS) on two occasions. Test–retest reliability (intraclass correlation coefficients) and convergent validity (Spearman correlations) of utility scores with global health status, activities of daily living, comorbidity, mood, cognition and other utility measures were assessed. Results: Completion time was shortest for the combined EQ-5D and VAS. For patients with mild dementia and for proxies, reliability was ≥ 0.70 for the EQ-5D, QWB and HUI3. The EQ-5D had a ceiling effect for patient ratings. Convergent validity was demonstrated for patient and proxy ratings, with the strongest validity for EQ-5D ratings and the weakest validity for HUI3 patient ratings. Mean patient utility scores were significantly higher than mean proxy scores for all measures (p<0.001). Conclusions: For patient and proxy ratings, the EQ-5D had the best combination of measurement properties, although it had a substantial ceiling effect for patient ratings. Proxy QOL ratings did not accurately reflect patients’ ratings.

Keywords

AlzheimersDementiaQuality of lifeUtility measurement

Copyright information

© Springer 2006