Search

Aim: To carry out an analysis of the psychometric properties of the Disease Burden Morbidity Assessment (DBMA) according to the assumptions of the Classical Test Theory. Methods: A sample of 707 community-dwelling adults aged 65 years and older, living in Spain, completed the DBMA. Psychometric properties of the scale (feasibility, acceptability, scaling assumptions, reliability and construct validity) were analyzed. Results: The mean DBMA score was 6.8. Feasibility and acceptability were satisfactory, except for large floor effects (>50%), as well as a skewed distribution (1.8). Item-total corrected correlation ranged 0.10–0.49, item homogeneity index was 0.09 and Cronbach's alpha was 0.72. Disease burden correlated strongly with physical functioning (r = –0.56) and perceived health (r = –0.56), and moderately with depression (r = 0.41) and the Personal Wellbeing Index (r = –0.41). Exploratory factor analysis extracted five factors, explaining 44% of the variance. Conclusions: The DBMA is an acceptable and valid instrument for measuring disease burden in older adults. Future studies should include Rasch analysis to further assess dimensionality and explore other measurement properties. [ABSTRACT FROM AUTHOR]

Background Health-related quality of life ( HRQOL) in older adults is determined by personal conditions, as well as by the social and physical environment. The purpose of the present study was to describe the factors related to health conditions and residential environment that influence HRQOL of older adults. Methods Data from 1815 cases came from three cross-sectional surveys on quality of life in older adults in Spain: non-institutionalized older adults ( n = 1106), institutionalized older adults without dementia ( n = 234) and institutionalized older adults with dementia ( n = 475). Assessment instruments used were: Barthel Index, Short Portable Mental Status Questionnaire, Comorbidity Index, EQ- 5D- 3L (5 dimensions, EQ-index and EQ-VAS), and information about sociodemographic characteristics and social networks. Partial correlation and multivariate logistic regression analyses were carried out. Results In group comparisons, institutionalized older adults showed a higher percentage of problems in the EQ- 5D- 3L dimensions than the non-institutionalized ones. Also, older adults with dementia presented less pain/discomfort and anxiety/depression than the other groups, but showed more problems in mobility, self-care and usual activities. EQ-Index showed a high association with functional independence, perceived health status and comorbidity. According to the logistic regression models, the Barthel Index was the most common determinant for most of EQ- 5D- 3L dimensions in all groups. Conclusion Institutionalized older adults with dementia presented lower HRQOL than the other groups. Functional independence, comorbidity and cognitive status were the main HRQOL determinants in all groups. Maintenance and improvement of the functional condition might be translated into a higher HRQOL of older adults. Geriatr Gerontol Int 2015; 15: 627-635. [ABSTRACT FROM AUTHOR]

Aim Measurement of health-related quality of life in people with dementia is a challenge, because of their special characteristics and the difficulties that this term entails itself. The present study aimed at assessing the psychometric properties of the EQ-5D rated by a familiar or a professional caregiver of institutionalized older adults with dementia. Methods We analyzed the EQ-5D psychometric properties from 525 questionnaires rated by proxy, in a sample of institutionalized older adults with dementia. Results The mean EQ-5D index score was 0.11 ± 0.38, and 51.54 ± 21.47 for the visual analog scale. The intraclass correlation coefficient was 0.72. Regarding internal consistency, Cronbach's alpha was 0.64, and the item-total correlation ranged from 0.33 to 0.53. Exploratory factor analysis identified a functional and a subjective factor, accounting for 67.35% of the variance. Convergent validity of EQ-5D with Quality of Life Alzheimer's Disease by proxy and Quality of Life in Late-stage Dementia scales was satisfactory ( r = 0.36-0.58). The EQ-5D showed appropriate discriminative validity among patients grouped into several categories. Multiple linear regression models, using EQ-index and visual analog scale as dependent variables, identified dependence level, proxy characteristics, leisure and comorbidity as determinants of quality of life. Conclusions Despite some limitations in the more subjective dimensions, the proxy-rated EQ-5D showed satisfactory psychometric properties in the present study, suggesting that it is a valid and alternative instrument to assess quality of life in institutionalized older people with dementia. Geriatr Gerontol Int 2014; 14: 346-353. [ABSTRACT FROM AUTHOR]

Aim The present study aimed at analyzing whether activity status is associated with self-perceived health status and quality of life ( QoL) in community-dwelling older adults. Methods We used a cross-sectional design based on a semi-structured QoL questionnaire in a representative sample of 1106 community-dwelling adults aged 60 years and older in Spain. Logistic regression models were used to explain the association of activity status with self-perceived health status and QoL, assessed by means of the EQ-5D-3L index, controlling for the influence of sociodemographic, social and support network variables, and health indicators. Results The mean age ± standard deviation was 72.1 ± 7.8 years. For the activity status, 8.5% were working people, 53.7% retirees, 30.6% homemakers and 7.2% pensioners. All homemakers and 93.6% pensioners were women. In the model to assess perceived health status, when controlling for sociodemographic, social and support network variables, we found that working people rated their health better than the retired group. In this model, pensioners rated their health status worst, whereas homemakers did not show any significant difference compared with the retired group. However, there were no differences in the model of QoL by activity status. Conclusion Activity status was associated with self-perceived health status, but not with QoL. This study draws attention to the need of considering the activity of older adults for actions aimed at maintaining and improving their health. Geriatr Gerontol Int 2014; 14: 464-473. [ABSTRACT FROM AUTHOR]