The influence of age on health valuations: the older olds prefer functional independence while the younger olds prefer less morbidity
Publication year
2015Source
Clinical Interventions in Aging, 10, (2015), pp. 1131-9ISSN
Publication type
Article / Letter to editor

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Organization
Health Evidence
Geriatrics
Journal title
Clinical Interventions in Aging
Volume
vol. 10
Page start
p. 1131
Page end
p. 9
Subject
Radboudumc 0: Other Research RIHS: Radboud Institute for Health Sciences; Radboudumc 13: Stress-related disorders DCMN: Donders Center for Medical Neuroscience; Radboudumc 18: Healthcare improvement science RIHS: Radboud Institute for Health Sciences; Radboudumc 1: Alzheimer`s disease DCMN: Donders Center for Medical NeuroscienceAbstract
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. CONCLUSION: 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.
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