Undercoverage of the elderly institutionalized population: The risk of biased estimates and the potentials of weighting Special issue

Jan-Lucas Schanze, GESIS - Leibniz Institute for the Social Sciences, Germany
Stefan Zins, GESIS - Leibniz Institute for the Social Sciences, Germany


In most social surveys, the elderly institutionalized population is not part of the target population because it is considered as hard-to-reach and hard-to-interview. The deliberate exclusion of institutionalized elderly from survey samples might cause bias, like previous studies investigating institutionalized elderly persons and their transition to institutions implied. We use a Monte Carlo simulation based on cross-national samples of the Survey of Health, Ageing and Retirement in Europe (SHARE) to test whether the noncoverage and undercoverage of the elderly institutionalized population lead to biased estimates. Moreover, we examined to what extent weights could be used to correct for the underrepresentation …


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How to reach ‘hard-to-reach’ older people for research: The TIBaR model of recruitment Special issue

Kerstin Kammerer, Institute for Gerontological Research, Torstraße 178, D-10115 Berlin, Germany
Katrin Falk, Institute for Gerontological Research, Torstraße 178, D-10115 Berlin, Germany
Anna Herzog, Institute for Gerontological Research, Torstraße 178, D-10115 Berlin, Germany
Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62-66, D-12101 Berlin, Germany


Recruiting older persons with diverse health statuses as participants in research projects is a challenge for health researchers, particularly because persons with health impairments and in socially disadvantaged living conditions are difficult to reach. This article presents a step model for gaining access to older people who are difficult to contact. The step model is based on the literature and a qualitative analysis of documentation, field notes and memos that stem from the recruitment processes of two studies from the German research consortium ‘Autonomy despite multimorbidity in old age’, both of which also included older persons who would qualify as …


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Interviewing elderly in nursing homes – Respondent and survey characteristics as predictors of item nonresponse Special issue

Patrick Kutschar, Institute of Nursing Science and Practice, Paracelsus Medical University, Salzburg, Austria (patrick.kutschar@pmu.ac.at)
Martin Weichbold, Department of Sociology, Paris Lodron University, Salzburg, Austria (martin.weichbold@sbg.ac.at)


Survey methodology is applied regularly in medical, nursing or social science studies examining elderly populations. Research in nursing home residents, where age-related or pathological declines in cognitive function are highly prevalent, faces several methodological challenges. The quality of survey data may be subject to population-specific measurement errors. In this article, data of two studies about pain in nursing homes are used to examine which respondent-, survey- and item characteristics predict item nonresponse. Chances for non-substantial answers are higher for older residents, for females and for those with more cognitive impairment. If residents are in pain, valid answers are more likely. …


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Effects of a sequential mixed-mode design on participation, contact and sample composition – Results of the pilot study “IMOA – Improving Health Monitoring in Old Age” Special issue

Beate Gaertner*, Robert Koch Institute (RKI), Berlin, Germany
Denise Lüdtke*, Robert Koch Institute (RKI), Berlin, Germany
Carmen Koschollek, Robert Koch Institute (RKI), Berlin, Germany
Maike M Grube, Robert Koch Institute (RKI), Berlin, Germany
Jens Baumert, Robert Koch Institute (RKI), Berlin, Germany
Christa Scheidt-Nave, Robert Koch Institute (RKI), Berlin, Germany
Antje Gößwald, Robert Koch Institute (RKI), Berlin, Germany
Judith Fuchs, Robert Koch Institute (RKI), Berlin, Germany
Matthias Wetzstein, Robert Koch Institute (RKI), Berlin, Germany
*shared first authorship


Existing health survey data of individuals who are 65+ years of age is limited due to the exclusion of the oldest old and physically or cognitively impaired individuals. This study aimed to assess the effects of a sequential mixed-mode design on (1) contact and response rates, (2) sample composition and (3) non-response bias. A register-based random sample of 2,000 individuals 65+ years was initially contacted by mail to answer a health questionnaire. Random subgroups of initial non-responders were further contacted by telephone or home visits. Participation by interview or proxy was possible. After postal contact only, the initial contact and …


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Including nursing home residents in a general population health survey in Germany Special issue

Beate Gaertner, Robert Koch Institute (RKI), Berlin, Germany
Carmen Koschollek, Robert Koch Institute (RKI), Berlin, Germany
Maike M. Grube, Robert Koch Institute (RKI), Berlin, Germany
Denise Lüdtke, Robert Koch Institute (RKI), Berlin, Germany
Judith Fuchs, Robert Koch Institute (RKI), Berlin, Germany
Christa Scheidt-Nave, Robert Koch Institute (RKI), Berlin, Germany
Antje Gößwald, Robert Koch Institute (RKI), Berlin, Germany
Matthias Wetzstein, Robert Koch Institute (RKI), Berlin, Germany


Nursing home residents (NHRs) are systematically excluded from the target populations of most population-based health surveys, which may result in biased prevalence estimates. Researchers who wish to include NHRs in surveys face several challenges including difficulty sampling and contacting NHRs and greater levels of functional impairments impeding participation. A population-wide, register-based, random sample of 8,000 older individuals (57.1% women, mean age=76.2 years) in six primary sampling units (PSUs) in Germany was used to analyse NHR coverage. The contact and response rates among NHRs were compared to those among persons living in private households in two PSUs (N=2,000) by applying an …


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