Patient- and proxy-reported utility in Alzheimer disease using the EuroQoL.
This study aims to compare patient- and proxy-rated utilities and health-related quality of life from individuals in different stages of Alzheimer disease (AD). Two hundred seventy-two patients and their primary caregivers were enrolled in a prospective observational study and underwent three consecutive interviews, 6 months apart. Average Mini-Mental State Examination (MMSE) scores were 19.3, 18.0, and 16.4 at the three interviews; scores ranged from 0 to 30. Using the EuroQoL EQ-5D instrument, patient-rated health utilities were on average 0.833 with little variation across MMSE-based severity levels. Proxy-rated health utilities were 0.69 (MMSE >25), 0.64 (MMSE 21-25), 0.50 (MMSE 15-20), 0.49 (MMSE 10-14), and 0.33 (MMSE <10). Proxy-rated utilities, as well as changes in utilities over time, were significantly related to MMSE scores and inversely related to scores on a brief version of the neuropsychiatric inventory (NPI) and institutionalization. Utilities were highly correlated with the disease-specific quality of life instrument QoL-AD. The study shows that the EuroQoL can be used to rate utilities in Alzheimer disease, but there are important differences between patient- and proxy-ratings.
Neurotec, Section for Geriatric Epidemiology, Karolinska Institutet, Stockholm, Sweden. linus.j@healtheconomics.se
Linus
L
Jönsson
Niels
N
Andreasen
Lena
L
Kilander
Hilkka
H
Soininen
Gunhild
G
Waldemar
Harald
H
Nygaard
Bengt
B
Winblad
Maria Eriksdotter
ME
Jönhagen
Merja
M
Hallikainen
Anders
A
Wimo
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000401:mortality / Q000523:psychology; D017028:Caregivers / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life / Q000523:psychology*; D019057:Quality-Adjusted Life Years; D013223:Statistics as Topic