Background Reference values are a helpful tool to facilitate comparisons of sampled values against a specified reference population. The aim is to describe the health profile and to provide visual analogue scale (EQ VAS) and utility reference values for the EQ-5D-5L from a normative sample of the general elderly population (65+) in Germany. Methods We analysed a sub-set of data from the German EQ-5D-5L valuation study using self-reported information based on EQ-5D-5L. We examined the share of respondents in each severity level per dimension as well as means, standard deviations (SD) and 95% confidence intervals for the index and EQ VAS values stratified by age groups and gender. Age was categorised in four groups (65–69, 70–74, 75–79 and > 79 years) to facilitate a more detailed examination of age-related health-related quality of life (HRQoL). Results The average index and EQ VAS scores were 0.84 (SD 0.22) and 73.2 (SD 18.5), respectively. In total, 21.4% reported no problems in all dimensions. With higher age, health problems were reported more frequently, which, in turn, lead to monotonically decreasing index and EQ VAS values. Overall, men reported fewer problems than women and this difference was largest beyond the age of 80. Conclusion HRQoL in the oldest old appears to be less stable and differs from the young elderly. However, the conventional age categorisation of earlier population norms studies seems to mask these differences. Hence, the more detailed provision of EQ-5D-5L reference values for the elderly population seems helpful for future German studies.

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Purpose The EQ-5D-3L and 5L are widely used generic preference-based instruments, which are psychometrically sound with the general population, but little is known about the instruments’ feasibility in the elderly. Therefore, this systematic review summarises the available literature with regard to the feasibility properties of the instruments in the elderly population. Methods We conducted a systematic search in PubMed, PsycInfo and EuroQol databases using pre-specified vocabulary and inclusion/exclusion criteria to identify publications until November 2020. Study characteristics and outcomes referring to the feasibility of the EQ-5D-3L and 5L in the elderly were extracted, if all study participants were at least 65+ years. Results We identified 17 studies reporting feasibility outcomes based on four criteria: missing values, completion rates, completion time and broad qualitative statements referring to the completion. Missing values per dimension ranged from 0 to 10.7%, although being mostly below 7%. The completion rate was around 90% or better, whereas the EQ VAS rating was missing from 2.3 to 25.3% of the respondents. Only two of the included studies examined the EQ-5D-5L; 15 studies reported on the EQ-5D-3L. Conclusion Comparing our findings against the general population from published literature, we find that feasibility outcomes in older age groups are just below that of younger populations. Furthermore, older respondents have a higher propensity of requiring assistance or even an interviewer-based approach. Nonetheless, the reviewed literature indicates that the EQ-5D-3L still has good feasibility properties and, hence, is highly applicable in older respondents. However, further research is needed to explore feasibility properties of the EQ-5D-5L in this population.

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