cloudThe 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 docx 143Kb.

Once you have completed the form please email a copy to Katie Breheny.

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 questionnaire

If you have any questions about using ICECAP-A in your study please contact Joanna Coast or Philip Kinghorn

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

Mirjam van Manen from Erasmus University Medical Centre, Rotterdam, has developed the following syntax for scoring ICECAP-O in SPSS.  Whilst we are sharing this syntax as a common resource, it is the responsibility of individual research teams to check the accuracy of the syntax should they choose to use it.

ICECAP-O Translations

A Welsh translation of ICECAP-O has been developed by Gwerfyl Roberts and colleagues in the School of Healthcare Sciences at Bangor University.

Obtain the Welsh translation of the questionnaire

A Dutch translation of ICECAP-O has been developed by Peter Makai and colleagues at Erasmus University, Netherlands.   Please acknowledge the source by citing: Makai P, Brouwer W, Koopmanschap M & Nieboer A (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 21(5): 801-12.

Obtain the Dutch translation of the questionnaire

A German translation of ICECAP-O has also been developed by Peter Makai. Please acknowledge the source by citing Makai P, Beckebans F, van Exel J, Brouwer WBF (2014) Quality of Life of Nursing Home Residents with Dementia: Validation of the German Version of the ICECAP-O. PLoS ONE 9(3): e92016. doi:10.1371/journal.pone.0092016

Obtain the German translation of the questionnaire

A Spanish version of the ICECAP-O has been developed by Marilyn K. Glassberg MD and colleagues at the University of Miami (contact Emmanuelle Simonet:

Obtain the Spanish version of the questionnaire

A Swedish translation of ICECAP-O has been developed by Professor Ingmar Skoog, Dr Helena Hörder and colleagues at the University of Gothenburg. 

Obtain the Swedish translation of the questionnaire

As part of the Actifcare (ACcess to TImely Formal Care) project, the ICECAP-O was translated for use in numerous EU countries, including: Germany, Italy, The Netherlands, Norway, Portugal  and Sweden.  Actifcare is an EU JPND funded European dementia research project.  If using one or more of these translations, please acknowledge the work of the Actifcare team by citing:

Kerpershoek, L., de Vugt, M., Wolfs, C., Jelley, H., Orrel, M., Woods, R., Stephan, A., Bieber, A., Meyer, G., Engedal, K., Selbeck, G., Handels, R., Wimo, A., Hopper, L., Irving, K., Marques, M., Gonçalves Pereira, M., Portolani, E., Zanetti, O., Verhey, F., and the Actifcare Consortium. (2016). Access to timely formal dementia care in Europe: Protocol of the Actifcare (ACcess to Timely Formal Care) Study. BMC Health Services Research, 16(1), 423. doi: 10.1186/s12913-016-1672-3

The ICECAP-O has been translated into French by a research team led by Dr Julien Delrieu at University Hospital of Toulouse, as part of the wider AMYPAD (Amyloid imaging to prevent Alzheimer’s Disease) Study.

Obtain the French translation of the questionnaire 

The ICECAP-O has been translated into Chinese by Judy Xu and colleagues from the Southwestern University of Finance and Economics, and the Guizhou Medical University, China.

Obtain the Chinese translation of the questionnaire

A Hungarian translation of ICECAP-O is available upon request from Philip Kinghorn.  The Hungarian translation of ICECAP-O was developed and validated by Márta Péntek* and colleagues from Corvinus University of Budapest (*now at Óbuda University (Budapest)). This research was supported by the Higher Education Institutional Excellence Program of the Ministry of Human Capacities in the framework of the 'Financial and Retail Services' research project (20764-3/2018/FEKUTSTRAT) at Corvinus University of Budapest.

A Japanese translation of ICECAP-O has been developed by Hideyuki Kobayashi from Research Center for Normative Economics, IER, Hitotsubashi University, as part of “the Implementation of Welfare Transportation System Based on the Capability Approach and Construction of Research Analysis Program.”  The work was funded by JSPS (Japanese Society for Promotion of Science) Basic Research A 19H00595. To obtain a version of the translation, please contact Philip Kinghorn.

Once again, please remember to register use with us before using any versions of the questionnaire by completing the registration form docx 143Kb and emailing to Katie Breheny.

For more information on developing translated versions of ICECAP-O please read the information contained on this general guide and contact Joanna Coast.


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.

Evidence about reliability, validity, and feasibility of use of ICECAP-O is described in:

Baji P, Farkas M, Dobos A, Zrubka Z, Gulácsi, L, Brodszky V, Rencz F & Péntek M. 2020 “Capability of well-being: validation of the Hungarian version of the ICECAP-A and ICECAP-O questionnaires and population normative data”.  Quality of Life Research.

Proud L, McLoughlin C, Kinghorn P. (2018) “ICECAP-O, The Current State of Play: A Systematic Review of Studies Reporting the Psychometric Properties and Use of the Instrument Over the Decade Since Its Publication”, Quality of Life Research. 28(6): 1429-1439.

Couzner L, Crotty M, Norman R & Ratcliffe J (2013) A comparison of the EQ-5D-3L and ICECAP-O in an older post-acute patient population relative to the general population.  Applied Economics & Health Policy. 11(4), 415-425

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

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.

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

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

Horder H, Gustafsson S, Rydberg T, Skoog I, Waern M. A Cross-Cultural Adaptation of the ICECAP-O: Test–Retest Reliability and Item Relevance in Swedish 70-Year-Olds. Societies 2016, 6(4), 30; doi: 10.3390/soc6040030

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

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.

Makai, P., Beckebans, F., van Exel, J., & Brouwer, W. B. (2014). Quality of life of nursing home residents with dementia: Validation of the German version of the ICECAP-OPLoS One, 9(3), e92016.

Use of the measure is outlined in the following papers:

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

Engel L, Chudyk AM, Ashe, MC, McKay HA, Whitehurst D, Bryan S (2016). Older adults' quality of life – Exploring the role of the built environment and social cohesion in community-dwelling seniors on low income.  Social Science and Medicine, Volume 164, pp1-11

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

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 (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:

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

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.  33(4): 547-557

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