Objective: The Global Activity Limitation Indicator (GALI), a single question measuring disability, had been introduced in various European surveys since 2004. The complexity of its wording has been questioned. Our study compares alternative variants aiming to simplify the wording. Method: We used the Health-Related Opinion Survey run in 2014 in France (N = 3,009). Its split sample design allows testing four variants of the questions. We analyzed the prevalence of activity limitation (AL) resulting from the four different constructs of the GALI using multinomial logistic regressions, adjusted for background variables and functional limitations (FLs). Results: The alternative GALI variants result in significantly different prevalences compared with the original question, in particular for people with FL. The current variant is more inclusive than the routed variants. Discussion: Our study suggests limited benefits of changing the GALI construct which do not outweigh the costs of breaking the established chronological series of the current variant.
BergerN.Van der HeydenJ.Van OyenH. (2015). The Global Activity Limitation Indicator and self-rated health: Two complementary predictors of mortality. Archives of Public Health, 73, Article 25.
2.
BergerN.Van OyenH. (2014). WP7: A blueprint for an internationally harmonised Summary Measure of Population Health (JA:EHLEIS Technical Report 2014_7.5, 1-34). Montpellier, France: European Health and Life Expectancy Information System. Retrieved from http://www.eurohex.eu/pdf/Reports_2014/2014_TR7%204_A%20blueprint.pdf
3.
BergerN.Van OyenH.CamboisE.FouweatherT.JaggerC.NusselderW.RobineJ.-M. (2015). Assessing the validity of the Global Activity Limitation Indicator in fourteen European countries. BMC Medical Research Methodology, 15(1). doi:10.1186/1471-2288-15-1
4.
Cabrero-GarciaJ.Julia-SanchisR. (2014). The Global Activity Limitation Index mainly measured functional disability, whereas self-rated health measured physical morbidity. Journal of Clinical Epidemiology, 67, 468-476. doi:10.1016/j.jclinepi.2013.10.005
5.
CamboisE.RobineJ.MormicheP. (2007). Did the prevalence of disability massively decreased in France over the 1990’s? A discussion of questions asked in the French health survey. Population-E, 62, 313-336.
6.
CoxB.Van OyenH.CamboisE.JaggerC.Le RoyS.RobineJ.-M.RomieuI. (2009). The reliability of the Minimum European Health Module. International Journal of Public Health, 54, 55-60.
7.
Eurostat. (2015). Global Activity Limitation Indicator (GALI) as a core variable. Directorate F: Social Statistics. Luxembourg: European Commission. DSS/2015/Sept/04.3, p42.
8.
JaggerC.GilliesC.CamboisE.Van OyenH.NusselderW.RobineJ.-M. (2010). The Global Activity Limitation Indicator (GALI) measured function and disability similarly across European countries. Journal of Clinical Epidemiology, 63, 892-899.
9.
KatzS.FordA.MoskowitzR.JacksonB.JaffeM. (1963). Studies of illness in the aged. The Index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914-919.
10.
LawtonM.BrodyE. (1969). Assessment of older people: Self-maintenance and Instrumental Activities of Daily Living. The Gerontologist, 9, 179-186.
11.
MadansJ. H.LoebM. E.AltmanB. M. (2011). Measuring disability and monitoring the UN Convention on the Rights of Persons with Disabilities: The work of the Washington Group on Disability Statistics. BMC Public Health, 11(Suppl. 4), Article S4.
12.
RechelB.GrundyE.RobineJ. M.CylusJ.MackenbachJ. P.KnaiC.McKeeM. (2013). Ageing in the European Union. The Lancet, 381, 1312-1322. doi:10.1016/S0140-6736(12)62087-X
13.
RobineJ.-M.CamboisE.NusselderW.JeuneB.Van OyenH.JaggerC. (2013). The joint action on healthy life years (JA: EHLEIS). Archives of Public Health, 71(1), 1-5.
14.
RobineJ.-M.JaggerC. (2003). Creating a coherent set of indicators to monitor health across Europe: The Euro-REVES 2 project. European Journal of Public Health, 13(3 Suppl.), 6-14.
RobineJ.-M.RavaudJ.-F.CamboisE. (1997). General concepts of disablement. In HamermanD. (Ed.), Osteoarthritis: Public health implication for an aging population (pp. 63-83). Baltimore, MD: Johns Hopkins University Press.
17.
TubeufS.JusotF.DevauxM.SermetC. (2008). Social heterogeneity in self-reported health status and measurement of inequalities in health. Paris, France: Institut de Recherche et Documentation en Economie de la Santé.
18.
Van der HeydenJ.BergerN.Van OyenH. (2015). Comparison of self-rated health and activity limitation as predictors of short term mortality in the older population. Public Health, 129, 283-285. doi:10.1016/j.puhe.2014.12.005
19.
Van der HeydenJ.BergerN.YokotaR.Van OyenH. (2015). Activity limitation predict health expenditures in the general population in Belgium. BMC Public Health, 15, Article 267. doi:10.1186/s12889-015-1607-7
20.
Van OyenH.Van der HeydenJ.PerenboomR.JaggerC. (2006). Monitoring population disability: Evaluation of a new Global Activity Limitation Indicator (GALI). Sozial- und Präventivmedizin, 51, 153-161.
21.
VerbruggeL.JetteA. (1994). The disablement process. Social Science & Medicine, 38, 1-14.
22.
VerropoulouG. (2014). Specific versus general self-reported health indicators predicting mortality among older adults in Europe: Disparities by gender employing SHARE longitudinal data. International Journal of Public Health, 59, 665-678.
23.
World Health Organization. (1980). International classification of impairments, disabilities, and handicaps. Geneva, Switzerland: Author.
24.
World Health Organization. (2001). International classification of functioning, disability and health: ICF. Geneva, Switzerland: Author.
