Do elder emergency department patients and their informants agree about the elder's functioning?

Area of Science:

• Gerontology
• Health Outcomes Research
• Patient-Reported Outcomes

Background:

• Assessing the functional status of elderly patients is crucial for effective healthcare management.
• Discrepancies between patient self-assessments and informant (proxy) reports can impact clinical decisions and research findings.

Purpose of the Study:

• To compare the self-reported physical and mental function of elderly patients with the ratings provided by their informants.
• To evaluate the reliability of the Medical Outcomes Study Short Form 12 (SF-12) when used for both patient and proxy assessments in older adults.

Main Methods:

• A randomized, cross-sectional study involving 106 elderly patients (>69 years) and 55 informants in a hospital emergency department.
• Patients were administered the SF-12 via interview or questionnaire (read aloud if necessary).
• Physical Component Scores (PCS) and Mental Component Scores (MCS) were calculated and compared between patient-informant pairs using statistical analyses.

Main Results:

• Patients reported significantly higher physical function (PCS) than their informants (mean difference 4.1 points, p=0.01).
• No significant difference was found in mental function (MCS) ratings between patients and informants (mean difference 0.49 points, p=0.79).
• The method of SF-12 administration (interview vs. questionnaire) did not significantly affect PCS or MCS scores.

Conclusions:

• Elderly individuals tend to overestimate their physical functioning compared to proxy reports.
• Self- and proxy-ratings of mental function in elders are comparable.
• Shifting from informant to patient reports for evaluating physical function in longitudinal studies may introduce bias and affect results.