Simple counts of ADL dependencies do not adequately reflect older adults' preferences toward states of functional impairment.

Journal of Clinical Epidemiology
Tamara SimsMary K Goldstein

Abstract

To use unweighted counts of dependencies in activities of daily living (ADLs) to assess the impact of functional impairment requires an assumption of equal preferences for each ADL dependency. To test this assumption, we analyzed standard gamble (SG) utilities of single and combination ADL dependencies among older adults. Four hundred older adults used multimedia software (FLAIR1) to report SG utilities for their current health and hypothetical health states of dependency in each of 7 ADLs and 8 of 30 combinations of ADL dependencies. Utilities for health states of multiple ADL dependencies were often greater than for states of single ADL dependencies. Dependence in eating, which is the ADL dependency with the lowest utility rating of the single ADL dependencies, ranked lower than 7 combination states. Similarly, some combination states with fewer ADL dependencies had lower utilities than those with more ADL dependencies. These findings were consistent across groups by gender, age, and education. Our results suggest that the count of ADL dependencies does not adequately represent the utility for a health state. Cost-effectiveness analyses and other evaluations of programs that prevent or treat functional dependency should apply...Continue Reading

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Citations

Feb 28, 2016·Social Science & Medicine·E Rodríguez-MíguezA R Sampayo
Mar 19, 2014·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Jing GuoWilliam Dale
Nov 11, 2008·Journal of Clinical Epidemiology·Robert L Kane
Jun 22, 2012·Journal of Advanced Nursing·Julianne BallardOrla Dempsey
Oct 10, 2014·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Jing GuoWilliam Dale
Mar 3, 2020·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Arlette EdjoloCécile Proust-Lima

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