Davis Jennifer C, Best John R, Dian Larry, Khan Karim M, Hsu Chun Liang, Chan Wency, Cheung Winnie, Liu-Ambrose Teresa
Center for Hip Health and Mobility, Robert HN Ho Building 2635 Laurel St, Vancouver, BC, V5Z 1M9, Canada.
Djavad Mowafaghian Centre for Brain Health, University of British Columbia, 2211 Wesbrook Mall, Vancouver, BC, V6T 2B5, Canada.
Qual Life Res. 2017 Mar;26(3):737-747. doi: 10.1007/s11136-016-1487-z. Epub 2016 Dec 22.
Preference-based generic measures are gaining increased use in mobility research to assess health-related quality of life and wellbeing. Hence, we examined the responsiveness of these two measures among individuals at risk of mobility impairment among adults aged ≥70 years.
We conducted a 12-month prospective cohort study of community-dwelling older adults (n = 288 to n = 341 depending on analysis) who were seen at the Vancouver Falls Prevention Clinic who had a history of at least one fall in the previous 12 months. We compared the responsiveness of the EuroQol-5 Domain-3 Level (EQ-5D-3L) and the index of capability for older adults (ICECAP-O) by examining changes in these measures over time (i.e., over 6 and 12 months) and by examining whether their changes varied as a function of having experienced 2 or more falls over 6 and 12 months.
Only the ICECAP-O showed a significant change over time from baseline through 12 months; however, neither measure showed change that exceeded the standard error of the mean. Both measures were responsive to falls that occurred during the first 6 months of the study (p < .05). These effects appeared to be amplified among individuals identified as having mild cognitive impairment (MCI) at baseline (p < .01). Additionally, the EQ-5D-3L was responsive among fallers who did not have MCI as well as individuals with MCI who did not fall (p < .05).
This study provides initial evidence suggesting that the EQ-5D-3L is generally more responsive, particularly during the first 6 months of falls tracking among older adults at risk of future mobility impairment.
基于偏好的通用测量方法在 mobility 研究中越来越多地用于评估与健康相关的生活质量和幸福感。因此，我们研究了这两种测量方法在≥70 岁有 mobility 障碍风险的成年人中的反应性。
我们对温哥华跌倒预防诊所就诊的社区居住老年人进行了为期 12 个月的前瞻性队列研究（根据分析，n = 288 至 n = 341），这些老年人在过去 12 个月中至少有过一次跌倒史。我们通过检查这些测量方法随时间（即 6 个月和 12 个月）的变化，以及检查它们的变化是否因在 6 个月和 12 个月内经历 2 次或更多次跌倒而有所不同，来比较欧洲五维度健康量表-3 水平（EQ-5D-3L）和老年人能力指数（ICECAP-O）的反应性。
只有 ICECAP-O 从基线到 12 个月随时间有显著变化；然而，两种测量方法的变化均未超过均值的标准误差。两种测量方法对研究前 6 个月内发生的跌倒均有反应（p <.05）。在基线时被确定为患有轻度认知障碍（MCI）的个体中，这些影响似乎被放大了（p <.01）。此外，EQ-5D-3L 在没有 MCI 的跌倒者以及没有跌倒的 MCI 个体中也有反应（p <.05）。
本研究提供了初步证据，表明 EQ-5D-3L 通常反应性更强，尤其是在对未来有 mobility 障碍风险的老年人进行跌倒追踪的前 6 个月。
