Estimating multiple morbidity disease burden among older persons: a convergent construct validity study to discriminate among six chronic illness measures, CCHS 2008/09

BMC Geriatrics

Ian Fyffe²  Lauren E Griffith³  Mélanie Levasseur¹  Andrew V Wister² 

[1] School of Rehabilitation, Pavillon Gérald-Lasalle, local Z7-2524, Faculty of Medicine and Health Sciences Université de Sherbrooke, Sherbrooke, Canada;Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver V6B 5K3, BC, Canada;Canadian Longitudinal Study on Aging (CLSA) Étude longitudinale canadienne sur le vieillissement (ÉLCV), Hamilton, Canada

关键词: Older adults;    Validation;    Surveys;    Multimorbidity indices;   

Others  :  1131199
DOI  :  10.1186/s12877-015-0001-8

 received in 2014-07-28, accepted in 2015-01-20,  发布年份 2015

【 摘 要 】

Background

Since approximately two in three older adults (65+) report having two or more chronic diseases, causes and consequences of multimorbidity among older persons has important personal and societal issues. Indeed, having more than one chronic condition might involve synergetic effects, which can increase impact on disabilities and quality of life of older adults. Moreover, persons with multimorbidity require more health care treatments, implying burden for the person, her/his family and the health care system.

Methods

Using the 2008/09 Canadian Community Health Survey (CCHS), this paper assesses the convergent construct validity of six measures of multimorbidity for persons aged 65 and over. These measures include: 1) Multimorbidity Dichotomized (0, 1+ conditions); 2) Multimorbidity Dichotomized (0/1, 2+); 3) Multimorbidity Additive Scale; 4) Multimorbidity Weighted by the Health Utility (HUI3) Scale; 5) Multimorbidity Weighted by the OARS Activity of Daily Living (ADL) Scale; and 6) Multimorbidity Weighted by HUI3 (using beta coefficients). Convergent construct validity was assessed using correlations and OLS regression coefficients for each of the multimorbidity measures with the following social-psychological and health outcome variables: life satisfaction, perceived health, number of health professional visits, and medication use.

Results

Overall, the two dichotomies (scales #1 & #2) showed the weakest construct validity with the health outcome variables. The additive chronic illness scale (#3) and the multimorbidity weighted by ADLs (#5), performed better than the other two weighted scales using (HUI #4 & #6). Measurement errors apparent in the dichotomous multimorbidity measures were amplified for older women, especially for life satisfaction and perceived health, but decreased when using the scales, suggesting stronger validity of scales #3 through #6.

Conclusions

To properly represent multimorbidity, using dichotomous measures should be used with caution. When only prevalence data are available for chronic conditions, such as in the CCHSs or CLSA, an additive multimorbidity scale can better measure total illness burden than simple dichotomous or other discrete measures.

【 授权许可】

   
2015 Wister et al.; licensee BioMed Central.

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