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Assessing quality of life in the elderly: a direct comparison of the EQ-5D and AQoL


  • Richard Holland

    (School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK)

  • Richard D Smith

    (School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK)

  • Ian Harvey

    (School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK)

  • Louise Swift

    (School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK)

  • Elizabeth Lenaghan

    (School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, UK)


As more research is undertaken on the elderly, accurately assessing changes in their quality of life becomes increasingly important. Generic instruments are the most popular method to assess quality of life, and one of the most widely used is the EQ-5D. However, the range of dimensions, sensitivity of scales and completion rates have been raised as concerns when using this measure with the elderly. The AQoL is a newer instrument which offers greater richness in dimensions of health covered, and potentially offers greater sensitivity to changes in quality of life. This paper presents the results of a 'head-to-head' comparison of the EQ-5D and AQoL in terms of practicality, construct validity, agreement (of absolute scores and their change over time) and sensitivity to change, as part of a randomised controlled trial in the elderly. Poor agreement was found between both the absolute scores from each instrument and change in scores over time. Although the AQoL appeared to have more favourable construct validity, the EQ-5D was easier to administer, had a higher completion rate, and appeared more sensitive to change. We conclude that the AQoL is probably less well suited to measuring health status in a very elderly population than the EQ-5D. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • Richard Holland & Richard D Smith & Ian Harvey & Louise Swift & Elizabeth Lenaghan, 2004. "Assessing quality of life in the elderly: a direct comparison of the EQ-5D and AQoL," Health Economics, John Wiley & Sons, Ltd., vol. 13(8), pages 793-805.
  • Handle: RePEc:wly:hlthec:v:13:y:2004:i:8:p:793-805 DOI: 10.1002/hec.858

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    References listed on IDEAS

    1. Torrance, George W., 1986. "Measurement of health state utilities for economic appraisal : A review," Journal of Health Economics, Elsevier, vol. 5(1), pages 1-30, March.
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    3. van Agt, Heleen M. E. & Essink-Bot, Marie-Louise & Krabbe, Paul F. M. & Bonsel, Gouke J., 1994. "Test-retest reliability of health state valuations collected with the EuroQol questionnaire," Social Science & Medicine, Elsevier, vol. 39(11), pages 1537-1544, December.
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    Cited by:

    1. Nalin Payakachat & Mir Ali & J. Tilford, 2015. "Can The EQ-5D Detect Meaningful Change? A Systematic Review," PharmacoEconomics, Springer, vol. 33(11), pages 1137-1154, November.
    2. Stirling Bryan & Louise Longworth, 2005. "Measuring health-related utility:," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(3), pages 253-260, September.
    3. Mulhern, B & Smith, SC & Rowen, D & Brazier, JE & Knapp, M & Lamping, DL & Loftus, V & Young, Tracey A. & Howard, RJ & Banerjee, S, 2010. "Improving the measurement of QALYs in dementia: developing patient- and carer-reported health state classification systems using Rasch analysis," MPRA Paper 29948, University Library of Munich, Germany.
    4. Janelle Seymour & Paul McNamee & Anthony Scott & Michela Tinelli, 2010. "Shedding new light onto the ceiling and floor? A quantile regression approach to compare EQ-5D and SF-6D responses," Health Economics, John Wiley & Sons, Ltd., vol. 19(6), pages 683-696.
    5. Susan T. Stewart & Rebecca M. Woodward & Allison B. Rosen & David M. Cutler, 2005. "A Proposed Method for Monitoring U.S. Population Health: Linking Symptoms, Impairments, and Health Ratings," NBER Working Papers 11358, National Bureau of Economic Research, Inc.
    6. Julie A. Campbell & Andrew J. Palmer & Alison Venn & Melanie Sharman & Petr Otahal & Amanda Neil, 2016. "A Head-to-Head Comparison of the EQ-5D-5L and AQoL-8D Multi-Attribute Utility Instruments in Patients Who Have Previously Undergone Bariatric Surgery," The Patient: Patient-Centered Outcomes Research, Springer;Johns Hopkins Bloomberg School of Public Health, vol. 9(4), pages 311-322, August.

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