Quality of Life Research

, Volume 15, Issue 4, pp 631–643

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

  • Gary Naglie
  • George Tomlinson
  • Catherine Tansey
  • Jane Irvine
  • Paul Ritvo
  • Sandra E. Black
  • Morris Freedman
  • Michel Silberfeld
  • Murray Krahn
Article

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

Alzheimers Dementia Quality of life Utility measurement 

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Copyright information

© Springer 2006

Authors and Affiliations

  • Gary Naglie
    • 1
    • 2
    • 3
    • 4
    • 5
  • George Tomlinson
    • 3
    • 6
    • 7
  • Catherine Tansey
    • 6
    • 9
  • Jane Irvine
    • 8
    • 16
  • Paul Ritvo
    • 8
    • 13
    • 14
  • Sandra E. Black
    • 4
    • 10
  • Morris Freedman
    • 4
    • 11
    • 12
    • 15
  • Michel Silberfeld
    • 16
  • Murray Krahn
    • 1
    • 3
    • 4
    • 5
  1. 1.Division of General Internal Medicine and Clinical EpidemiologyUniversity Health NetworkTorontoCanada
  2. 2.Geriatrics ProgramToronto Rehabilitation InstituteTorontoCanada
  3. 3.Clinical Epidemiology and Health Care Research ProgramUniversity of TorontoTorontoCanada
  4. 4.Department of MedicineUniversity of TorontoTorontoCanada
  5. 5.Department of Health Policy, Management and EvaluationUniversity of TorontoTorontoCanada
  6. 6.Department of MedicineUniversity Health NetworkTorontoCanada
  7. 7.Department of Public Health SciencesUniversity of TorontoTorontoCanada
  8. 8.Department of PsychologyYork UniversityTorontoCanada
  9. 9.Institute of Medical ScienceUniversity of TorontoTorontoCanada
  10. 10.Division of NeurologySunnybrook and Women’s College Health Sciences CentreTorontoCanada
  11. 11.Division of NeurologyMount Sinai HospitalTorontoCanada
  12. 12.Behavioural Neurology Program and Rotman Research InstituteBaycrest Centre for Geriatric CareTorontoCanada
  13. 13.Cancer Care OntarioTorontoCanada
  14. 14.Ontario Cancer InstituteTorontoCanada
  15. 15.Division of NeurologyUniversity Health NetworkTorontoCanada
  16. 16.Department of PsychiatryUniversity of TorontoTorontoCanada

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