Comparability of Information Provided by Elderly Cancer Patients and Surrogates Regarding Health and Functional Status, Social Network, and Life Events

Abstract

Stressful life events may adversely affect health, but these effects may be mitigated by a strong social support network. The elderly should be a focus for investigation in this area, but epidemiologic studies in the elderly are often complicated by the need to rely upon information collected from surrogates. We assessed the degree to which 622 elderly cancer patients and surrogates agreed in their answers to questions about life events, social network, and health and functional status. We compared spouses, friends, and children as surrogates by evaluating (1) their agreement with index subjects and (2) the proportion of surrogates of each type who could not answer one or more questions. Agreement for most items on health and functional status was at least moderately good, but agreement was more inconsistent for questions about social network and major life events. Agreement was higher when factual information was solicited than when the question regarded more personal information or attitudes. For questions about health status, social network, and life events, spouses agreed more closely with index subjects than did children or friends. For questions about functional status, however, agreement did not vary consistently by respondent type. We found no consistent effects of the index subject's age or cognitive status on levels of agreement, nor did we find evidence of bias in the surrogates' responses.