The ICECAP-O (ICEpop CAPability measure for Older people) is a measure of capability in older people for use in economic evaluation. Unlike most profile measures used in economic evaluations, the ICECAP-O focuses on wellbeing defined in a broader sense, rather than health. The measure covers attributes of wellbeing that were found to be important to older people in the UK.

ICECAP-O comprises five attributes (the lay terms are in brackets):

  • Attachment (love and friendship)
  • Security (thinking about the future without concern)
  • Role (doing things that make you feel valued)
  • Enjoyment (enjoyment and pleasure)
  • Control (independence)

The ICECAP-O descriptive system was developed using qualitative methods. A set of index values for the ICECAP-O have been estimated using a best-worst scaling study of older people in England.

ICECAP-O is free to use, but the use of the measure must be registered with us first. More details on the registration, index values and applications of the ICECAP-O can be found on this website.

Registering to use ICECAP-O...

Before using ICECAP-O in your study please register with us first. You do not have to pay to use the measure, but please complete the registration form.

Once you have completed the form please email a copy to Philip Kinghorn

ICECAP-O Questionnaire...

You can download a copy of the ICECAP-O questionnaire by clicking on the following link: ICECAP-O questionnaire

Please remember to register  with us before you start using the form

A Welsh translation of ICECAP-O has been developed by Heledd Owen and colleagues in the School of Healthcare Sciences at Bangor University. You can obtain the Welsh translation of the questionnaire by clicking here.

A Dutch translation of ICECAP-O has also been developed by Peter Makai and colleagues at Erasmus University, Netherlands. You can request the translated version of the questionnaire by contacting Philip Kinghorn

Once again, please remember to register use with us before using any versions of the questionnaire.

For more information on developing translated versions of ICECAP-O contact Joanna Coast

UK index values for the ICECAP-O are presented in:

Coast J, Flynn T, Natarajan L, Sproston K, Lewis J, Louviere J et al. Valuing the ICECAP capability index for older people. Social Science and Medicine 2008; 67(5):874-882.

Please click here to download the STATA code to score the ICECAP-O instrument



Empirical references:

The selection of attributes for the ICECAP-O is described in:

Grewal I, Lewis J, Flynn T, Brown J, Bond J, Coast J. Developing attributes for a generic quality of life measure for older people: preferences or capabilities? Social Science and Medicine 2006; 62:1891-1901.

UK index values for the ICECAP-O are presented in:

Coast J, Flynn T, Natarajan L, Sproston K, Lewis J, Louviere J et al. Valuing the ICECAP capability index for older people. Social Science and Medicine 2008; 67(5):874-882.

An assessment of the ICECAP-O is described in:

Horwood J, Sutton E, Coast J. Evaluating the face validity of the ICECAP-O capabilities measure: a “think-aloud” study with hip and knee arthroplasty patients. Applied Research in Quality of Life. Online first: doi:10.1007/s11482-013-9264-4

Coast J, Peters T, Natarajan L, Sproston K, Flynn T. An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people. Quality of Life Research 2008; 17:967-976.

Makai P, Brouwer W, Koopmanschap MA, Nieboer AP (2012). Capabilities and quality of life in Dutch psycho-geriatric nursing homes: an exploratory study using a proxy version of the ICECAP-O. Quality of Life Research, Volume 21, Issue 5, pp 801-812

Makai P, Koopmanschap MA, Brouwer WB, & Nieboer AP. (2013). A validation of the ICECAP-O in a population of post-hospitalized older people in the Netherlands. Health and quality of life outcomes, 11(1), 57.

Theory and methods references:

Coast J, Smith R, Lorgelly P. Should the capability approach be applied in health economics? Health Economics 2008; 17:667-670.

Flynn TN, Louviere JJ, Peters TJ, Coast J. Best-Worst Scaling: What it can do for health care research and how to do it. Journal of Health Economics 2007;26(1):171-89

Flynn T, Chan P, Coast J, Peters TJ (2011). Assessing quality of life among British older people using the ICEPOP CAPability (ICECAP-O) measure. Applied Health Economics and Health Policy, Volume 9, Issue 5, pp 317-329

Davis JC, Liu-Ambrose T, Richardson CG, Bryan S (2012). A comparison of the ICECAP-O with EQ-5D in a falls prevention clinical setting: are they complements or substitutes? Quality of Life Research, DOI 10.1007/s11136-012-0225-4

Couzner L, Ratcliffe J, Lester L, Flynn T, Crotty M (2012). Measuring and valuing quality of life for public health research: application of the ICECAP-O capability index in the Australian general population. International Journal of Public Health, September

Couzner L, Ratcliffe J, Crotty M (2012). The relationship between quality of life, health and care transition: an empirical comparison in an older post-acute population. Health and Quality of Life Outcomes, 10:69

Mitchell PM, Roberts TE, Barton PM, Pollard BS, Coast J (2013). Predicting the ICECAP-O Capability Index from the WOMAC Osteoarthritis Index: Is Mapping onto Capability from Condition-Specific Health Status Questionnaires Feasible? Medical Decision Making, doi: 10.1177/0272989X12475092

Davis JC, Bryan S, McLeod R, Rogers J, Khan K, Liu-Ambrose T (2012). Exploration of the association between quality of life, assessed by the EQ-5D and ICECAP-O, and falls risk, cognitive function and daily function, in older adults with mobility impairments. BMC Geriatrics, 12:65 doi:10.1186/1471-2318-12-65

Ratcliffe J, Lester LH, Couzner L, Crotty M (2013). An assessment of the relationship between informal caring and quality of life in older community-dwelling adults – more positives than negatives? Health & Social Care in the Community; 21:35–46

Henderson C, Knapp M, Fernández JL, Beecham J, Hirani SP, Cartwright M, Rixon L, Beynon M, Rogers A, Bower P, Doll H, Fitzpatrick R, Steventon A, Bardsley M, Hendy J, Newman SP, for the Whole System Demonstrator evaluation team (2013). Cost effectiveness of telehealth for patients with long term conditions (Whole Systems Demonstrator telehealth questionnaire study): nested economic evaluation in a pragmatic, cluster randomised controlled trial. BMJ; 346 doi:  

ICECAP-O Applications...

The ICECAP-O measure is currently being used as an outcome measure in a number of trials and evaluations predominantly in social care and public health. It has been used in the UK, Australia, North America and the Netherlands and a Dutch translation of the measure has recently been developed. If you are interested in finding out whether the ICECAP-O might be appropriate for your study please contact Joanna Coast