Clinimetrics; Frailty; Patient-reported outcome measure; Psychometrics; Quality of life
Abstract :
[en] BACKGROUND: The SarQoL® questionnaire was specifically designed to measure quality of life (QoL) in sarcopenia. Frailty and sarcopenia have areas of overlap, notably weak muscle strength and slow gait speed, which may mean that the SarQoL could provide a measure of QoL in frailty. This study aimed to evaluate the clinimetric properties of the SarQoL questionnaire in physical frailty using the Fried criteria. METHODS: Analyses were carried out on data from the Sarcopenia and Physical impairment with advancing Age study. Frailty was assessed with the Fried criteria and QoL with the SarQoL, the Short-Form 36-Item, and the EuroQoL 5-Dimension (EQ-5D) questionnaires. We evaluated discriminative power (with the Kruskal-Wallis analysis of variance test), internal consistency (with Cronbach's alpha), construct validity (through hypotheses testing), test-retest reliability (with the intraclass correlation coefficient), measurement error (calculating standard error of measurement and smallest detectable change), and responsiveness (through hypotheses testing and standardized response mean). RESULTS: In total, 382 participants were included for the validation and 117 for the responsiveness evaluation. They had a median age of 73 (69-79) years, took 5 (3-8) drugs, and had 4 (3-5) co-morbidities. There were more women (n = 223; 58.4%) than men and, in total, 172 (45%) robust, 167 (44%) pre-frail, and 43 (11%) frail participants. Discriminative power was confirmed when significantly lower (P < 0.001) overall SarQoL scores, and thus also worse QoL, were observed between robust [77.1 (64.35-85.90)], pre-frail [62.54 (53.33-69.57)], and frail [49.99 (40.45-56.06)] participants. Six of the SarQoL domains performed likewise, with significantly lower scores according to frailty status with Domain 7 (fears) being the exception. Internal consistency was good (α = 0.866). Convergent (using Short-Form 36-Item and EQ-5D) and divergent construct validity (using EQ-5D) was confirmed. Test-retest reliability was excellent [intraclass correlation coefficient = 0.918 (0.834-0.961)], with a standard error of measurement of 3.88 and a smallest detectable change of 10.76 points. We found moderate responsiveness when five of the nine hypotheses were confirmed, coupled with a large effect size for the overall SarQoL score (corrected standardized response mean of -1.44). CONCLUSIONS: The SarQoL questionnaire has adequate clinimetric properties for use with frail patients in clinical practice and trials and could provide data that are more appropriate and detailed than the generic questionnaires currently used.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Geerinck, Anton ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Locquet, Médéa ; Université de Liège - ULiège > Département des sciences de la santé publique > Epidémiologie clinique
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Beaudart, Charlotte ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Evaluating quality of life in frailty: applicability and clinimetric properties of the SarQoL(®) questionnaire.
World Health Organisation. Decade of healthy ageing. 2020 https://www.who.int/docs/default-source/decade-of-healthy-ageing/final-decade-proposal/decade-proposal-final-apr2020-en.pdf?sfvrsn=b4b75ebc_3
WHO Clinical Consortium on Healthy Ageing. Report of consortium meeting 1–2 December 2016 in Geneva, Switzerland. Geneva; 2017.
Vermeiren S, Vella-Azzopardi R, Beckwée D, Habbig AK, Scafoglieri A, Jansen B, et al. Frailty and the prediction of negative health outcomes: a meta-analysis. J Am Med Dir Assoc 2016;17:1163.e1–1163.e17.
Collard RM, Boter H, Schoevers RA, Oude Voshaar RC. Prevalence of frailty in community-dwelling older persons: a systematic review. J Am Geriatr Soc 2012;60:1487–1492.
O'Caoimh R, Galluzzo L, Rodríguez-Loso A, Van der Heyden J, Ranhoff A, Lemprini-Koula M, et al. Prevalence of frailty at population level in European ADVANTAGE Joint Action Member States: a systematic review and meta-analysis. Ann Ist Super Sanita 2018;54:226–238.
Buckinx F, Rolland Y, Reginster J-Y, Ricour C, Petermans J, Bruyère O. Burden of frailty in the elderly population: perspectives for a public health challenge. Arch Public Health 2015;73:19.
Crocker TF, Brown L, Clegg A, Farley K, Franklin M, Simpkins S, et al. Quality of life is substantially worse for community-dwelling older people living with frailty: systematic review and meta-analysis. Qual Life Res 2019;28:2041–2056.
Coons SJ, Rao S, Keininger DL, Hays RD. A comparative review of generic quality-of-life instruments. Pharmacoeconomics 2000;17:13–35.
Wiebe S, Guyatt G, Weaver B, Matijevic S, Sidwell C. Comparative responsiveness of generic and specific quality-of-life instruments. J Clin Epidemiol 2003;56:52–60.
Beaudart C, Biver E, Bruyère O, Cooper C, Al-Daghri N, Reginster JY, et al. Quality of life assessment in musculo-skeletal health. Aging Clin Exp Res 2018;30 (5):413–418.
Beaudart C, Biver E, Reginster JY, Rizzoli R, Rolland Y, Bautmans I, et al. Development of a self-administrated quality of life questionnaire for sarcopenia in elderly subjects: the SarQoL. Age Ageing 2015;44:960–966.
Beaudart C, Edwards M, Moss C, Reginster JY, Moon R, Parsons C, et al. English translation and validation of the SarQoL®, a quality of life questionnaire specific for sarcopenia. Age Ageing 2017;46:271–277.
Beaudart C, Biver E, Reginster JY, Rizzoli R, Rolland Y, Bautmans I, et al. Validation of the SarQoL®, a specific health-related quality of life questionnaire for sarcopenia. J Cachexia Sarcopenia Muscle 2017;8:238–244.
Geerinck A, Scheppers A, Beaudart C, Bruyère O, Vandenbussche W, Bautmans R, et al. Translation and validation of the Dutch SarQoL®, a quality of life questionnaire specific to sarcopenia. J Musculoskelet Neuronal Interact 2018;18:463–472.
Konstantynowicz J, Abramowicz P, Glinkowski W, Taranta E, Marcinowicz L, Dymitrowicz M, et al. Polish validation of the SarQoL®, a quality of life questionnaire specific to sarcopenia. J Clin Med 2018;7:323.
Gasparik AI, Mihai G, Beaudart C, Bruyere O, Pop R-M, Reginster J-Y, et al. Correction to: psychometric performance of the Romanian version of the SarQoL®, a health-related quality of life questionnaire for sarcopenia. Arch Osteoporos 2018;13:98.
Fábrega-Cuadros R, Martínez-Amat A, Cruz-Díaz D, Aibar-Almazán A, Hita-Contreras F. Psychometric properties of the Spanish version of the sarcopenia and quality of life, a quality of life questionnaire specific for sarcopenia. Calcif Tissue Int 2020;106:274–282.
Alekna V, Kilaite J, Tamulaitiene M, Geerinck A, Mastaviciute A, Bruyère O, et al. Validation of the Lithuanian version of sarcopenia-specific quality of life questionnaire (SarQoL®). Eur Geriatr Med 2019;10:761–767.
Tsekoura M, Billis E, Gliatis J, Tsepis E, Matzaroglou C, Sakkas GK, et al. Cross cultural adaptation of the Greek sarcopenia quality of life (SarQoL) questionnaire. Disabil Rehabil 2020;42(7):1006–1012.
Geerinck A, Alekna V, Beaudart C, Bautmans I, Cooper C, De Souza Orlandi F, et al. Standard error of measurement and smallest detectable change of the Sarcopenia Quality of Life (SarQoL) questionnaire: an analysis of subjects from 9 validation studies. PLoS One 2019;14:e0216065.
Geerinck A, Bruyère O, Locquet M, Reginster JY, Beaudart C. Evaluation of the responsiveness of the SarQoL® questionnaire, a patient-reported outcome measure specific to sarcopenia. Adv Ther 2018;35:1842–1858.
Cederholm T. Overlaps between frailty and sarcopenia definitions. Nestle Nutr Inst Workshop Ser 2015;83:65–69.
Sieber CC. Frailty—from concept to clinical practice. Exp Gerontol 2017;87:160–167.
Cruz-Jentoft AJ, Michel JP. Sarcopenia: a useful paradigm for physical frailty. Eur Geriatr Med 2013;4:102–105.
Beaudart C, Reginster JY, Petermans J, Gillain S, Quabron A, Locquet M, et al. Quality of life and physical components linked to sarcopenia: the SarcoPhAge study. Exp Gerontol 2015;69:103–110.
Locquet M, Beaudart C, Hajaoui M, Petermans J, Reginster JY, Bruyère O. Three-year adverse health consequences of sarcopenia in community-dwelling older adults according to 5 diagnosis definitions. J Am Med Dir Assoc 2019;20:43–46, e2.
Beaudart C, Locquet M, Touvier M, Reginster J-Y, Bruyère O. Association between dietary nutrient intake and sarcopenia in the SarcoPhAge study. Aging Clin Exp Res 2019;31:815–824.
Beaudart C, Sanchez-Rodriguez D, Locquet M, Reginster JY, Lengelé L, Bruyère O. Malnutrition as a strong predictor of the onset of sarcopenia. Nutrients 2019;11.
Locquet M, Beaudart C, Reginster JY, Bruyère O. Association between the decline in muscle health and the decline in bone health in older individuals from the SarcoPhAge cohort. Calcif Tissue Int 2019;104:273–284.
Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146–M156.
Taylor HL, Jacobs DR, Schucker B, Knudsen J, Leon AS, Debacker G. A questionnaire for the assessment of leisure time physical activities. J Chronic Dis 1978;31:741–755.
Roadolff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Measur 1977;1:385–401.
Safonova YA, Lesnyak OM, Baranova IA, Suleimanova AK, Zotkin EG. Russian translation and validation of SarQoL®—quality of life questionnaire for patients with sarcopenia. Nauchno-Prakticheskaya Revmatol 2019;57:38–45.
Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Med Care 1992;30:473–483.
Rabin R, de Charro F. EQ-5D: a measure of health status from the EuroQol Group. Ann Med 2001;33:337–343.
The EuroQol Group. EuroQol—a new facility for the measurement of health-related quality of life. Health Policy (New York) 1990;16:199–208.
Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol 2010;63:737–745.
de Vet HCW, Terwee CB, Mokkink LB. Measurement in Medicine: A Practical Guide. Cambridge: Cambridge University Press; 2011.
Davidson M. Known-Groups Validity. In Encyclopedia of Quality of Life and Well-being Research. Dordrecht: Springer Netherlands; 2014. p 3481–3482.
de Boer MR, Moll AC, de Vet HCW, Terwee CB, Völker-Dieben HJM, van Rens GHMB. Psychometric properties of vision-related quality of life questionnaires: a systematic review. Ophthalmic Physiol Opt 2004;24:257–273.
Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol 2000;53:459–468.
Terwee C, Bot S, de Boer M, van der Windt D, Knol D, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007;60:34–42.
Middel B, Van Sonderen E. Statistical significant change versus relevant or important change in (quasi) experimental design: some conceptual and methodological problems in estimating magnitude of intervention-related change in health services research. Int J Integr Care 2002;2.
Cohen J. Quantitative methods in psychology. Psychol Bull 1992;112:155–159.
Sprangers M, Schwartz C. Integrating response shift into health-related quality of life research: a theoretical model. Soc Sci Med 1999;48:1507–1515.
Schwartz CE, Rapkin BD. Reconsidering the psychometrics of quality of life assessment in light of response shift and appraisal. Health Qual Life Outcomes 2004;2:1–11.
Rodríguez-Mañas L, Féart C, Mann G, Viña J, Chatterji S, Chodzko-Zajko W, et al. Searching for an operational definition of frailty: a Delphi method based consensus statement. The Frailty Operative Definition-Consensus Conference Project. J Gerontol - Ser A Biol Sci Med Sci 2013;68:62–67.
Guyatt GH, Eagle J, Sacket B, Willan A, Griffith L, McIlroy W, et al. Measuring quality of life in the frail. J Clin Epidemiol 1993;46:1433–1444.
Xia W, Cooper C, Li M, Xu L, Rizzoli R, Zhu M, et al. East meets West: current practices and policies in the management of musculoskeletal aging. Aging Clin Exp Res 2019;31:1351–1373.
Cesari M, De Carvalho IA, Thiyagarajan JA, Cooper C, Martin FC, Reginster JY, et al. Evidence for the domains supporting the construct of intrinsic capacity. J Gerontol - Ser A Biol Sci Med Sci 2018;73:1653–1660.
Dent E, Kowal P, Hoogendijk EO. Frailty measurement in research and clinical practice: a review. Eur J Intern Med 2016;31:3–10.
Woolford SJ, Sohan O, Dennison EM, Cooper C, Patel HP. Approaches to the diagnosis and prevention of frailty. Aging Clin Exp Res 2020;32:1629–1637.
Moreno-Ariño M, Torrente Jiménez I, Cartanyà Gutiérrez A, Oliva Morera JC, Comet R. Assessing the strengths and weaknesses of the Clinical Frailty Scale through correlation with a frailty index. Aging Clin Exp Res 2020;32:2225–2232.
von Haehling S, Morley JE, Coats AJS, Anker SD. Ethical guidelines for publishing in the Journal of Cachexia, Sarcopenia and Muscle: update 2019. J Cachexia Sarcopenia Muscle 2019;10:1143–1145.