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Age and Ageing Advance Access originally published online on April 25, 2006
Age and Ageing 2006 35(4):376-381; doi:10.1093/ageing/afl003
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Factors affecting completion of the SF-36 in older people

Stuart G. Parker1, Dorothea Bechinger-English2, Carol Jagger3, Nicola Spiers3 and James Lindesay4

1 Sheffield Institute for Studies on Ageing, University of Sheffield, Barnsley Hospital NHS Foundation Trust, Gawber Road, Barnsley S75 2EP, UK
2 European Institute of Health and Medical Sciences (EIHMS), University of Surrey, Guildford GU2 7XH, UK
3 Division of Epidemiology and Public Health,
4 Division of Psychiatry, University of Leicester, 22–28 Princes Road West, Leicester LE1 6TP, UK

Address correspondence to: S. G. Parker. Fax: +44 (0) 114 2715771. Email: s.g.parker{at}sheffield.ac.uk

Objective: to examine the influence of specific clinical impairments and disabilities on the completion of the SF-36 health status measure among older people.

Design: Prospective observational study.

Setting/Participants: An SF-36 was administered to 245 subjects aged 65 years and older. Subjects were chosen by sampling from a variety of inpatient, outpatient and community sources to ensure a range of relevant disabilities.

Measurements: response rates, overall rates of completion, completion of individual questions and time taken to complete.

Results: severe functional impairment (Barthel index ≤12) was found in 22.4% (51/228), cognitive impairment in 54.1% (132/244), depressed mood in 77.0% (151/196) and visuospatial dysfunction in 71.3% (134/188). The median number of impairments was three (interquartile range 1–4). Specific physical impairments were visual in 13.2% (31/235), hearing in 30.2% (74/245), impaired manual dexterity in 18.0% (44/245) and dysphasia in 23% (55/239). In multivariate analyses, global functional impairment (P = 0.006), cognitive impairment (P = 0.0001) and impaired manual dexterity (P = 0.005) were significantly associated with more dimensions uncompleted, whilst cognitive impairment (P = 0.001), age (P = 0.006) and visuospatial dysfunction (P = 0.0003) were significantly associated with longer completion times.

Conclusion: the most striking finding of the study was that global rather than specific physical and mental dysfunction was associated with the inability to complete the SF-36 questionnaire. The difficulty appears to lie in the performance of a complex task, rather than with specific aspects of the task which could be overcome by adaptation or aids. Our experience is that this relatively complex questionnaire does not adequately measure functional health status in disabled older people because of non-completion and may therefore overestimate the health of populations.

Keywords: health status, SF-36, disability, old age, elderly


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