Testing the EQ-HWB-9 with seven-day versus today recall periods in dementia: variability and recall adherence under health fluctuations.

In 30 seconds

This mixed-methods randomized study compared “7-day” and “today” EQ-HWB-9 recall periods in people living with dementia and caregiver dyads recruited from German primary care. Across two weeks, caregivers recorded daily health fluctuations, while dyads completed the questionnaire on days 1, 7 and 14. Among 74 dyads, caregivers reported at least one fluctuation for 92% of participants, and fluctuations were associated with greater score variability. Recall adherence also differed by fluctuation level: caregivers favored “today” when fluctuations were absent or low and “7-day” when they were high. The findings suggest no single recall period suits all participants.

Key findings

• Caregivers reported at least one health fluctuation in 92% of people with dementia; fluctuations occurred in 41% of daily assessments.
• Greater diary-documented health fluctuation was associated with greater variability in EQ-HWB-9 scores.
• Caregivers of people with no-to-low fluctuations favored “today,” while those reporting high fluctuations favored the “7-day” recall period.
• Proxy EQ-HWB-9 scores indicated worse health than self-reports and were higher with “7-day” than “today” recall.

Why it matters

Recall period can shape reported health and well-being in dementia, where day-to-day health changes are common. The observed relationship between fluctuations, score variability and caregiver recall adherence highlights the importance of considering fluctuation patterns when interpreting questionnaire results. This may help researchers and clinicians understand why assessments using different recall windows do not necessarily capture the same experience.

What to keep in mind

The study involved 74 dyads from German primary care and assessed questionnaire responses over two weeks; the findings may not generalize to other settings or longer-term assessment.