title: Quality of life of nursing home residents with dementia: validation of the German version of the ICECAP-O.
abstract: OBJECTIVE
  To validate the ICECAP-O capability wellbeing measure's German translation in older people with dementia living in a nursing home, and to investigate the influence of proxy characteristics on responses.
  
  
  METHODS
  Cross-sectional study. For 95 residents living in a German nursing home, questionnaires were completed by nursing professionals serving as proxy respondents. We investigated the convergent validity of the ICECAP-O with other Quality of Life (Qol) measures, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer's Disease Related Quality of Life (ADRQL) measures, and the Barthel-index measure of Activities of Daily Living (ADL). Discriminant validity was investigated using bivariate and multivariate stepwise regression analysis, comparing ICECAP-O scores between subgroups varying in dementia severity, care dependency, ADL status and demographic characteristics.
  
  
  RESULTS
  Convergent validity between the ICECAP-O, EQ-5D+C, ADRQL and Barthel-Index scores was moderate to good (with correlations of 0.72, 0.69 and 0.53 respectively), but differed considerably between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.58 below 65 points on the Barthel-index and 0.80 above 65 points) and other characteristics. The ICECAP-O scores based on available tariffs were related to proxy characteristics gender (0.52 males versus 0.65 females) and work experience (0.61 below 2 years of experience versus 0.68 above 2 years).
  
  
  CONCLUSIONS
  The results of this study suggest that the ICECAP-O is a promising generic measure for general Qol and capability of people with dementia living in a nursing home. Validity tests generally yielded favorable results. Work experience and gender appeared to influence proxy response, which raises questions regarding appropriate proxies, especially since the ICECAP-O may be completed by proxies relatively often. Further research is necessary to validate the German version of the ICECAP-O, with specific attention to proxy completion for people with dementia.
authors.affiliation: Department of Geriatrics, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Makai
authors.affiliation: Siemens Health Insurance Fund, Munchen, Germany.
authors.forename: Franziska
authors.initials: F
authors.lastname: Beckebans
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van Exel
authors.affiliation: Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands.
authors.forename: Werner B F
authors.initials: WB
authors.lastname: Brouwer
mesh_terms: D000368:Aged; D003704:Dementia; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D005858:Germany; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011788:Quality of Life; D011795:Surveys and Questionnaires