The influence of age on health valuations: the older olds prefer functional independence while the younger olds prefer less morbidity

Figures & data

Figure 1 Study framework.

Note: Framework: combining eight components into one generic composite endpoint (TOPICS-CEP) and the influence of rater characteristics.
Abbreviations: QOL, quality of life; TOPICS-CEP, The Older Persons and Informal Caregivers Survey – Composite Endpoint index.

Table 1 Linear mixed models with interaction terms between the raters’ age and each of the TOPICS-CEP components

	Estimates	95% confidence limits		P-value
Intercept	9.03	7.66	10.40	0.00**
Age (centered)	−0.01	−0.03	0.00	0.07
Morbidities	−0.14	−0.15	−0.12	0.00**
Functional limitations	−0.12	−0.13	−0.11	0.00**
Emotional wellbeing	−0.03	−0.04	−0.03	0.00**
Pain experience	−0.05	−0.11	0.02	0.16
Cognitive problems	−0.14	−0.22	−0.05	0.00**
Social functioning	0.01	−0.02	0.04	0.60
Self-perceived health	−0.16	−0.20	−0.12	0.00**
Self-perceived QOL	−0.02	−0.07	0.02	0.33
Morbidities × raters’ age	0.00	0.00	0.00	0.05*
Functional limitations × raters’ age	0.00	0.00	0.00	0.04*
Emotional wellbeing × raters’ age	0.00	0.00	0.00	0.42
Pain experience × raters’ age	0.01	0.00	0.01	0.02*
Cognitive problems × raters’ age	0.00	−0.01	0.01	0.88
Social functioning × raters’ age	0.00	−0.01	0.00	0.05*
Self-perceived health × raters’ age	0.00	−0.01	0.00	0.07
Self-perceived QOL × raters’ age	0.00	0.00	0.01	0.14

Notes: Dependent variable: general wellbeing score;

* P<0.05;

** P<0.01.

Abbreviations: QOL, quality of life; TOPICS-CEP, The Older Persons and Informal Caregivers Survey – Composite Endpoint index.

Table 2 TOPICS-CEP models based on the health state preferences of 65-year-old versus 85-year-old persons

	TOPICS-CEP-65	TOPICS-CEP-85
Intercept	9.14	8.85
Morbidities	−0.15	−0.12
Functional limitations	−0.11	−0.13
Emotional wellbeing	−0.04	−0.03
Pain experience	−0.09	0.03
Cognitive problems	−0.13	−0.14
Social functioning	0.03	−0.03
Self-perceived health	−0.14	−0.20
Self-perceived QOL	−0.05	0.02

Abbreviations: QOL, quality of life; TOPICS-CEP-65, The Older Persons and Informal Caregivers Survey – Composite Endpoint scores for 65-year-old persons; TOPICS-CEP-85, The Older Persons and Informal Caregivers Survey – Composite Endpoint scores for 85-year-old persons.

Figure 2 Bland–Altman plot of TOPIC-CEP scores of 65-year-old versus 85-year-old persons.

Notes: Bland–Altman plot: difference between CEP scores of the vignette cases based on preferences of 65-year-old versus 85-year-old persons plotted against their average. Bold solid line represents the average difference between methods; dotted lines represent the 95% confidence limits.
Abbreviations: QOL, quality of life; TOPICS-CEP-65, The Older Persons and Informal Caregivers Survey – Composite Endpoint scores for 65-year-old persons; TOPICS-CEP-85, The Older Persons and Informal Caregivers Survey – Composite Endpoint scores for 85-year-old persons.

Table S1 The health outcome domains, their preference weights, items per component, and levels per item

Outcome domains	Preference weights	Vignette items	Outcomes (levels)
Morbidity (local and national health monitor) van Oostrom et al^Citation1	0.13	Presence of: dementia; depression; incontinence; stroke, CVA or TIA; hip fracture; panic or anxiety disorder; dizziness with falling; vision disorder; asthma; osteoporosis; diabetes; arthritis; heart failure; form of cancer; complaints due to benign enlarged prostate; fracture other than hip fracture; hearing disorder	Number of diseases present; counting the number of health items “Present” Range: 0–17
Functional limitations (modified KATZ-ADL Index) Kind and Dolan^Citation2	0.12	Needing help with: brushing hair; going to the toilet; taking medication; sitting down and getting up from chair; getting dressed; traveling; handling finances; grocery shopping; walking about; taking a bath or shower; housekeeping; preparing a meal; eating; using the telephone	Number of limitations in (I)ADL; counting the number of physical functioning items “Help needed” Range: 0–15
Emotional wellbeing (RAND-36, mental health subscale) Wittenberg et al^Citation3	0.03	Feeling down; feeling blue; feeling nervous; feeling happy; feeling calm	Raw mental health score; Calculating the raw score of the five mental health items, each ranging from 1–6 (always – never) Range: 5–30
Pain experience (single-item EQ-5D+C) Löffler et al^Citation4	0.03	Pain experience	I have no pain I have moderate pain I have very severe pain
Cognitive functioning (single-item EQ-5D+C) Löffler et al^Citation4	0.14	Cognitive problems	I have no problems with my memory, attention and thinking I have some problems with my memory, attention and thinking I have severe problems with my memory, attention and thinking
Social functioning (single-item RAND-36) Wittenberg et al^Citation3	0.01	Social activities hampered by physical health or emotional problems	Never Rarely Sometimes Mostly Continuously
Self-perceived health (single item, RAND-36) Wittenberg et al^Citation3	0.17	Self-perceived health in general	Excellent Very good Good Reasonable Poor
Satisfaction with quality of life (single item formed using phrasing similar to self-perceived health question, RAND-36) Wittenberg et al^Citation3	0.02	Self-perceived QOL in general	Excellent Very good Good Reasonable Poor

Abbreviations: ADL, activities of daily living; CVA, cerebrovascular accident; (I)ADL, instrumental activities of daily living; QOL, quality of life; TIA, transient ischemic attack.

Table S2 The original TOPICS-CEP components’ weights and the weights adjusted for the age distribution of older persons (≥65 years old) in the Netherlands

	Original TOPICS-CEP weights	Adjusted TOPICS-CEP weights
Intercept	9.03	9.00
Morbidities	−0.14	−0.13
Functional limitations	−0.12	−0.12
Emotional wellbeing	−0.04	−0.03
Pain experience	−0.04	−0.03
Cognitive problems	−0.13	−0.14
Social functioning	−0.01	−0.01
Self-perceived health	−0.16	−0.17
Self-perceived QOL	−0.03	−0.02

Abbreviations: QOL, quality of life; TOPICS-CEP, The Older Persons and Informal Caregivers Survey – Composite Endpoint score.

Lokale en Nationale Monitor GezondheidIndicatoren voor de monitor gezohdheid ouderen [Indicators to monitor health in the elderly] [webpage on the Internet]Bilthoven, the NetherlandsRijksinstituut voor Volksgezondheid en Milieu2005 Available from: https://www.monitorgezondheid.nl/gezondheidindicatoren.aspxAccessed May 15, 2013 Dutch

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