• geriatric medicine;
  • caregivers;
  • epidemiologic research design;
  • outcome assessment;
  • data collection;
  • interviews


  1. Top of page
  2. Abstract
  3. References

Objective: To compare elder patients' and their informants' ratings of the elder's physical and mental function measured by a standard instrument, the Medical Outcomes Study Short Form 12 (SF-12). Methods: This was a randomized, cross-sectional study conducted at a university-affiliated community teaching hospital emergency department (census 65,000/year). Patients >69 years old, arriving on weekdays between 10 AM and 7 PM, able to engage in English conversation, and consenting to participate were eligible. Patients too ill to participate were excluded. Informants were people who accompanied and knew the patient. Elder patients were randomized 1:1 to receive an interview or questionnaire version of the SF-12. The questionnaire was read to people unable to read. Two trained medical students administered the instrument. The SF-12 algorithm was used to calculate physical (PCS) and mental (MCS) component scores. Oral and written versions were compared using analysis of variance. The PCS and MCS scores between patient-informant pairs were compared with a matched t-test. Alpha was 0.05. Results: One hundred six patients and 55 informants were enrolled. The patients' average (±SD) age was 77 ± 5 years; 59 (56%; 95% CI = 46% to 65%) were women. There was no significant difference for mode of administration in PCS (p = 0.53) or MCS (p = 0.14) scores. Patients rated themselves higher on physical function than did their proxies. There was a 4.1 (95% CI = 99 to 7.2) point difference between patients' and their proxies' physical component scores (p = 0.01). Scores on the mental component were quite similar. The mean difference between patients and proxies was 0.49 (95% CI = 3.17 to 4.16). The half point higher rating by patients was not statistically significant (p = 0.79). Conclusions: Elders' self-ratings of physical function were higher than those of proxies who knew them. There was no difference in mental function ratings between patients and their proxies. Switching from informants' to patients' reports in evaluating elders' physical function in longitudinal studies may introduce error.


  1. Top of page
  2. Abstract
  3. References
  • 1
    Miller DK, Lewis LM, Nork MJ, Morley JE. Controlled trial of a geriatric case-finding and liaison service in an emergency department. J Am Geriatr Soc 1996; 44: 51320.
  • 2
    McCusker J., Cardin S., Bellavance F., Belzile E. Return to the emergency department by elders: patterns and predictors. Acad Emerg Med 2000; 7: 24959.
  • 3
    Ware JE Jr, Kosinski M., Keller SD. A 12-item short-form health survey. Med Care 1996; 34: 22033.
  • 4
    Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 47383.
  • 5
    SPSS. SPSS 8.0 for Windows: brief guide, Chicago , IL : SPSS, 1998.
  • 6
    Mundinger MO, Kane RL, Lenz ER. Primary care outcomes in patients treated by nurse practitioners or physicians: a randomized trial. JAMA 2000; 283: 5968.
  • 7
    Ware JE, Snow KK, Kosinski M., Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston , MA : New England Medical Center, The Health Institute, 1993.
  • 8
    Magaziner J., Zimmerman SI, Gruber-Baldini AL, Hebel JR, Fox KM. Proxy reporting in five areas of health status: comparison with self-reports and observations of performance. Am J Epidemiol 1997; 146: 41828.
  • 9
    Rubenstein LZ, Schairer C., Wieland GD, Kane R. Systematic biases in functional status assessments of elderly adults: effects of different data sources. J Gerontol 1984; 39: 68691.
  • 10
    Epstein AM, Hall JA, Tognetti J., Son LH, Conant L. Jr. Using proxies to evaluate quality of life: can they provide valid information about patients' health status and satisfaction with medical care? Med Care 1989; 27(suppl):S9198.
  • 11
    Weinberger M., Samsa GP, Schmader K., Greenberg SM, Carr DB, Wildman DS. Comparing proxy and patients' perceptions of patient's functional status: results from an outpatient geriatric clinic. J Am Geriatr Soc 1992; 40: 5858.