title: Overall Quality of Life (OQoL) questionnaire in frail elderly: a study of reproducibility and responsiveness of the Depression List (DL).
abstract: BACKGROUND
  The DL is a generic interview-based questionnaire and previously validated in measuring OQoL in nursing home residents. Our aim was to examine its reproducibility and responsiveness in the frail elderly.
  
  
  METHODS
  The design was three repeated DL-measures 10, 30 and 365 days on consecutively recruited hip fracture patients with residence in nursing homes and sheltered housing facilities and with a Mini Mental State Examination (MMSE) score of 5 or more. The DL-questionnaire consists of 15 questions covering emotional well-being, social relationship, life-satisfaction, comfort, functional competence and autonomy. The scale ranges from 0 (=best OQoL) to score 30 (=worst OQoL). A trained occupational therapist did face-to-face interviews for measuring intra-rater reliability with 20 days interval, and 365 days after hip fracture surgery measuring responsiveness after recovery. Inter-rater reliability was evaluated by two raters in a subgroup.
  
  
  RESULTS
  130 residents were eligible and completed the test-retest (86%). The systematic difference was 0.49 points (95% confidence interval: -0.25; 1.23). Standard Error of Measurement (SEM) was 3.02 points, and the Minimal Detectable Change (MDC) was 8.37 points. Intra-class Correlation Coefficient (ICC) was 70%. Evaluating responsiveness, 89 patients (87%) were alive and completed the third interview. The DL improved over time (p<0.001) and was associated with improved physical recovery after hip fracture. The inter-rater reliability was high (ICC=97%).
  
  
  CONCLUSIONS
  The DL-questionnaire is easy to use in the frail elderly. It has an acceptable reproducibility, and is able to detect a clinically relevant change over time.
authors.affiliation: Department of Geriatrics, Aarhus University Hospital, P. P. Oerumsgade 11, 8000 Aarhus C, Denmark. Electronic address: meregreg@rm.dk.
authors.forename: Merete
authors.initials: M
authors.lastname: Gregersen
authors.affiliation: Department of Geriatrics, Aarhus University Hospital, P. P. Oerumsgade 11, 8000 Aarhus C, Denmark.
authors.forename: Mette M
authors.initials: MM
authors.lastname: Jordansen
authors.affiliation: Department of Primary and Community Care, Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Centre, Comeniuslaan 4, 6525 HP Nijmegen, The Netherlands.
authors.forename: Debby L
authors.initials: DL
authors.lastname: Gerritsen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003863:Depression / Q000523:psychology*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006620:Hip Fractures; D006801:Humans; D008297:Male; D009735:Nursing Homes; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Frailty; Nursing homes; Quality of Life; Questionnaire; Reliability; Responsiveness