title: The influence of age on health valuations: the older olds prefer functional independence while the younger olds prefer less morbidity.
abstract: BACKGROUND
  To assess the effectiveness of geriatric interventions, The Older Persons and Informal Caregivers Survey - Composite Endpoint (TOPICS-CEP) has been developed based on health valuations of older persons and informal caregivers. This study explored the influence of the raters' age on the preference weights of TOPICS-CEP's components.
  
  
  METHODS
  A vignette study was conducted with 200 raters (mean age ± standard deviation: 72.5±11.8 years; 66.5% female). Profiles of older persons were used to obtain the preference weights for all TOPICS-CEP components: morbidity, functional limitations, emotional well-being, pain experience, cognitive functioning, social functioning, self-perceived health, and self-perceived quality of life. The raters assessed the general wellbeing of these vignettes on a 0-10 scale. Mixed linear regression analysis with interaction terms was used to explore the effects of raters' age on the preference weights.
  
  
  RESULTS
  Interaction effects between age and the TOPICS-CEP components showed that older raters gave significantly (P<0.05) more weight to functional limitations and social functioning and less to morbidities and pain experience, compared to younger raters.
  
  
  CONCLUSIONS
  Researchers examining effectiveness in elderly care need to consider the discrepancies between health valuations of younger olds and older olds when selecting or establishing outcome measures. In clinical decision making, health care professionals need to be aware of this discrepancy as well. For this reason we highly recommend shared decision making in geriatric care.
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands ; Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Cynthia S
authors.initials: CS
authors.lastname: Hofman
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: Makai
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands.
authors.forename: Han
authors.initials: H
authors.lastname: Boter
authors.affiliation: Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Bianca M
authors.initials: BM
authors.lastname: Buurman
authors.affiliation: Department of Gerontology and Geriatrics, Leiden University Medical Centre, Leiden, the Netherlands.
authors.forename: Anton J
authors.initials: AJ
authors.lastname: de Craen
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
authors.affiliation: Department for Health Evidence, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: Rogier
authors.initials: R
authors.lastname: Donders
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, the Netherlands.
authors.forename: René J F
authors.initials: RJ
authors.lastname: Melis
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003071:Cognition; D003657:Decision Making; D005260:Female; D006304:Health Status; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009426:Netherlands; D010146:Pain / Q000453:epidemiology; D057240:Patient Preference / Q000523:psychology*; D011788:Quality of Life
keywords: age; composite endpoint; domains; general wellbeing; preferences; valuation