MHOS Survey Data

Physical and Mental Health

SEER-MHOS measures physical and mental health using the Veterans Rand VR-12 (Since 2006) and SF-36 (1998-2005). SF-36 sub-scale and summary scores have been calibrated to the VR-12. For more information, refer to our Bridging SF-36 and VR-12 webpage.

The Physical Component Summary (PCS) and Mental Component Summary (MCS) were previously re-scored to be equivalent across the cohorts/years of data collection and these variables (labeled PCS12 and MCS12) are already available in the data resource.

The MHOS includes eight sub-scales from SF-36 and VR-12 calibration:

• physical functioning
• role limitation (physical)
• pain
• general health
• emotional well-being
• role limitation (emotional)
• social functioning
• energy/fatigue

All VR-12 summary and subscale scores have been adjusted by survey mode and language.

General Health

The CDC Healthy Days Measure captures an individual’s mental and physical health, as well as its impacts on regular activities, such as self-care, work, and recreation, over a 30-day period.

For measure history and scoring

Activities of Daily Living

Activities of daily living (ADL) are the tasks of everyday life. A reported difficulty in ADLs can indicate a loss of self-care capabilities and negatively impact quality of life.

Cognitive Function

Three validated survey items were added in 2013. Two items (Difficulty concentrating and difficulty doing errands) are from the American Community Survey. One item Memory problems is from the National Health and Aging Trends Study (NHATS).

Example questions:

• Because of a physical, mental, or emotional condition, do you have serious difficulty concentrating, remembering or making decisions?
• Because of a physical, mental, or emotional condition, do you have difficulty doing errands alone such as visiting a doctor’s office or shopping?
• In the past month, how often did memory problems interfere with your daily activities?

Instrumental Activities of Daily Living

Instrumental Activities of Daily Living (IADLs) refer to a set of more complex tasks that are necessary for independent living and functioning within society. IADLs encompass activities that are more cognitively and physically demanding than basic care (represented by ADLs).

Example question:

• Because of a health or physical problem, do you have any difficulty doing the following activities? A) Preparing meals B) Managing money C)Taking medications as prescribed

Vision and Hearing

In 2013, vision and hearing questions were reworded, and the direction of the responses was reversed.

Example questions:

• Are you blind or do you have serious difficulty seeing, even when wearing glasses?
• Are you deaf or do you have serious difficulty hearing, even with a hearing aid?

For details about scoring please see our MHOS Measures Guide (PDF, 2.6 MB).

Depression

Beginning with the 2013 HOS 2.5, two depression screening questions from the Patient Health Questionnaire-2 (PHQ-2) replaced the depression screening measure in previous versions of the HOS. (Questions 36-39 on the 2012 HOS 2.0 Instrument.)

Example question:

• Over the past 2 weeks, how often have you been bothered by any of the following problems? a) Little interest or pleasure in doing things? b) Feeling down, depressed, or hopeless?

Pain Interference and Intensity

PROMIS is a set of patient-reported outcome (PRO) measures that evaluate physical, mental, and social health in adults and children. It can be used with the general population and with individuals living with chronic conditions.¹¹ Pain interference and pain intensity questions used in the HOS are taken from the PROMIS Profile-29 v1.0, modified to fit the needs of the HOS instrument.^11,12 The HOS 2.5 was first implemented in the Cohort 16 Baseline (and Cohort 14 Follow Up) survey fielded in 2013.

Example questions:

• In the past 7 days, how much did pain interfere with your day to day activities?
• In the past 7 days, how often did pain keep you from socializing with others?
• In the past 7 days, how would you rate your pain on average?

Sleep Duration and Quality

The sleep duration and quality items are derived from the Pittsburgh Sleep Quality Index (PSQI).²⁷

Example questions:

• During the past month, on average, how many hours of actual sleep did you get at night? (This may be different from the number of hours you spent in bed.
• During the past month, how would you rate your overall sleep quality?

For details about scoring please see our MHOS Measures Guide (PDF, 2.6 MB).

Management of Urinary Incontinence in Older Adults

Urinary incontinence (UI) may cause a wide range of morbidities, including cellulitis, pressure ulcers, urinary tract infections, falls with fractures, sleep deprivation, social withdrawal, depression, and sexual dysfunction.^22,23 Beneficiaries with UI are not often being asked about their UI by a health care professional.²⁴ Consequently, UI remains significantly underreported and underdiagnosed.²⁵

The Healthcare Effectiveness Data and Information Set (HEDIS®)b HOS question “how much of a problem, if any, was urine leakage” was updated to: “how much did leaking of urine change the daily activities or interfere with sleep.”

Example question:

• During the past six months, how much did leaking of urine make you change your daily activities or interfere with your sleep?

For details about scoring please see our MHOS Measures Guide (PDF, 2.6 MB).

For detailed information about SEER-MHOS Participants Educational Attainment, Smoking Status… please visit the Demographic Information webpage.

Primary Language Spoken at Home

The question which asked how well you speak English was revised to ask what language you mainly speak at home.

Example question:

• What language do you mainly speak at home?
  • English
  • Spanish
  • Chinese
  • Some other language (please specify)

Living Arrangements

The living arrangement questions were derived from living arrangement items used in other large population-based studies of older adults.

Example questions:

• Do you live alone or with others? (One or more categories may be selected)
• Where do you live?
  • House, apartment, condominium or mobile home
  • Assisted living or board and care home
  • Nursing home
  • Other

For details about scoring please see our MHOS Measures Guide (PDF, 2.6 MB).