title: Utility-based Quality of Life measures in Alzheimer's disease.
abstract: OBJECTIVE
  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 >or= 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.
authors: Division of General Internal Medicine and Clinical Epidemiology, University Health Network, Toronto, Ontario, Canada. naglie.gary@tornotorehab.on.ca
authors: Gary
authors: G
authors: Naglie
authors: George
authors: G
authors: Tomlinson
authors: Catherine
authors: C
authors: Tansey
authors: Jane
authors: J
authors: Irvine
authors: Paul
authors: P
authors: Ritvo
authors: Sandra E
authors: SE
authors: Black
authors: Morris
authors: M
authors: Freedman
authors: Michel
authors: M
authors: Silberfeld
authors: Murray
authors: M
authors: Krahn