Quality of life in older people: a structured review of generic self-assessed health instruments.
OBJECTIVE
To review evidence relating to the measurement properties of multi-item generic patient or self-assessed measures of health in older people.


METHODS
Systematic literature searches to identify instruments. Pre-defined criteria relating to reliability, validity and responsiveness.


RESULTS
122 articles relating to 15 instruments met the inclusion criteria. The most extensive evidence was found for the SF-36, COOP Charts, EQ-5D, Nottingham Health Profile (NHP) and SIP. Four instruments have evidence of both internal consistency and test-retest reliability--NHP, SF-12, SF-20, SF-36. Four instruments lack evidence of reliability--HSQ-12, IHQL, QWB, SQL. Most instruments were assessed for validity through comparisons with other instruments, global judgements of health, or clinical and socio-demographic variables. Five instruments lack evidence of responsiveness--GQL, HSQ-12, IHQL, QLI and QWB.


CONCLUSIONS
There is good evidence for reliability, validity and responsiveness for the SF-36, EQ-5D and NHP. There is more limited evidence for the COOP, SF-12 and SIP. The SF-36 is recommended where a detailed and broad ranging assessment of health is required, particularly in community dwelling older people with limited morbidity. The EQ-5D is recommended where a more succinct assessment is required, particularly where a substantial change in health is expected. Instrument content should be assessed for relevance before application. The concurrent evaluation of generic instruments in older people is recommended.
Haywood
K L
KL
National Centre for Health Outcomes Development, Unit of Health-Care Epidemiology, Department of Public Health, University of Oxford, Oxford, UK. kristie.haywood@uhce.ox.ac.uk
Garratt
A M
AM
Fitzpatrick
R
R
D000367:Age Factors; D000368:Aged; D006305:Health Status Indicators; D006801:Humans; D011788:Quality of Life; D015203:Reproducibility of Results; D012649:Self Concept