Subject-caregiver response comparability on global health and functional status measures for African American, Puerto Rican, and Caucasian elders and their primary caregivers

Abstract

Ethnic differences in response comparability and bias were evaluated for elderly African American, Puerto Rican, and non-Hispanic Caucasian elderly subjects with some degree of disability and their caregivers. Responses were compared for items assessing basic and instrumental activities of daily living, memory problems, confusion, and global health status. In general, for all ethnic groups, response comparability, based on kappa, was only poor to fair, with the lowest agreement found for items assessing memory problems and confusion. When disagreements occurred, caregivers tended to overestimate impairment relative to the elderly subjects, regardless of ethnicity. However, there were very few significant differences between the response patterns of the caregivers of these different ethnic groups. Thus, although there may be bias in the responses of caregivers relative to elderly persons, in general further bias is not introduced by ethnic differences in comparability of caregiver responses for elders with same degree of disability.