title: Measurement properties of the EQ-5D across four major geriatric conditions: Findings from TOPICS-MDS.
abstract: BACKGROUND
  As populations age, chronic geriatric conditions linked to progressive organ failure jeopardize health-related quality of life (HRQoL). Thus, this research assessed the validity and applicability of the EQ-5D (a common HRQoL instrument) across four major chronic geriatric conditions: hearing issues, joint damage, urinary incontinence, or dizziness with falls.
  
  
  METHODS
  The study sample comprised 25,637 community-dwelling persons aged 65 years and older residing in the Netherlands (Data source: TOPICS-MDS, www.topics-mds.eu ). Floor and ceiling effects were examined. To assess convergent validity, random effects meta-correlations (Spearman's rho) were derived between individual EQ-5D domains and related survey items. To further examine construct validity, the association between sociodemographic characteristics and EQ-5D summary scores were assessed using linear mixed models. Outcomes were compared to the overall study population as well as a 'healthy' subgroup reporting no major chronic conditions.
  
  
  RESULTS
  Whereas ceiling effects were observed in the overall study population and the 'healthy' subgroup, such was not the case in the geriatric condition subgroups. The majority of hypotheses regarding correlations between survey items and sociodemographic associations were supported. EQ-5D summary scores were lower in respondents who were older, female, widowed/single, lower educated, and living alone. Increasing co-morbidity had a clear negative effect on EQ-5D scores.
  
  
  CONCLUSIONS
  This study supported the construct validity of the EQ-5D across four major geriatric conditions. For older persons who are generally healthy, i.e. reporting few to no chronic conditions, the EQ-5D confers poor discriminative ability due to ceiling effects. Although the overall dataset initially suggested poor discriminative ability for the EQ-5D, such was not the case within subgroups presenting with major geriatric conditions.
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Postbus 9101, Nijmegen, 6500 HB, Netherlands.
authors.forename: Jennifer E
authors.initials: JE
authors.lastname: Lutomski
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
authors.forename: Paul F M
authors.initials: PF
authors.lastname: Krabbe
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: Bleijenberg
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands.
authors.forename: Jeanett
authors.initials: J
authors.lastname: Blom
authors.affiliation: Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.
authors.forename: Gertrudis I J M
authors.initials: GI
authors.lastname: Kempen
authors.affiliation: Department. of General Medicine, Academic Medical Center, Amsterdam, Netherlands.|Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Janet
authors.initials: J
authors.lastname: MacNeil-Vroomen
authors.affiliation: Department of General Practice and Elderly Care Medicine/EMGO+ Institute for Health and Care Research, VU Medical Center, Amsterdam, Netherlands.
authors.forename: Maaike E
authors.initials: ME
authors.lastname: Muntinga
authors.affiliation: Department of Public Health, Erasmus MC University Medical Center, Rotterdam, Netherlands.
authors.forename: Ewout
authors.initials: E
authors.lastname: Steyerburg
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Postbus 9101, Nijmegen, 6500 HB, Netherlands.
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde-Rikkert
authors.affiliation: Department of Geriatric Medicine, Radboud University Medical Center, Postbus 9101, Nijmegen, 6500 HB, Netherlands. rene.melis@radboudumc.nl.
authors.forename: René J F
authors.initials: RJ
authors.lastname: Melis
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D002908:Chronic Disease; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D009426:Netherlands; D011788:Quality of Life / Q000523:psychology*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Dizziness; EQ-5D; Hearing loss; Joint diseases; Quality of life; Urinary incontinence