Tay Lyn Xuan, Ong Siew Chin, Ong Hui Ming, Teh Ewe Eow, Ch'ng Alan Swee Hock, Tiong Ing Khieng, Razali Rizah Mazzuin, Parumasivam Thaigarajan
Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
Discipline of Social and Administrative Pharmacy, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
Value Health Reg Issues. 2025 Jul;48:101122. doi: 10.1016/j.vhri.2025.101122. Epub 2025 May 16.
There were only a few studies that assessed health-related quality of life (HRQoL) of patients with Alzheimer disease (AD) in Malaysia. This cross-sectional study was to investigate the HRQoL scores of patients with AD in Malaysia using 2 HRQoL instruments and to identify predictors of patients' HRQoL.
Informal caregivers of patients with AD were recruited in 4 tertiary hospitals during outpatient visits. Patients' HRQoL was assessed using proxy-rated generic (EQ-5D-5L and EQ-VAS), and disease-specific (Quality-of-life Alzheimer's Disease [QoL-AD]) assessment instruments were utilized to obtain proxy HRQoL scores of patients with AD from caregivers via structured interviews. The difference between HRQoL scores and other variables was tested using analysis of variance. Pearson correlation test was conducted between the 2 instruments, whereas a multivariable linear regression model was utilized to identify predictors of HRQoL in patients with AD.
The mean EQ-5D-5L index, EQ-VAS, and QoL-AD score of patients with AD were 0.63 ± 0.30, 61.05 ± 20.48, and 26.69 ± 6.83, respectively, via proxy ratings. In terms of correlation, EQ-5D was weakly correlated with QoL-AD (r = 0.36, P < .01). EQ-5D index and QoL-AD score reduced significantly as AD advanced (P < .05). Besides, cognitive decline, presence of behavioral symptoms, female caregiver gender, and nonmarried status were associated with lower patients' HRQoL in multivariable models with EQ-5D index (P < .05).
Low HRQoL of patients with AD requires attention from healthcare providers and stakeholders in optimal resource allocation and decision making. Such health utility values are useful in future economic evaluations in investigating the cost-effectiveness of new interventions or disease-modifying therapies.
在马来西亚，仅有少数研究评估了阿尔茨海默病（AD）患者的健康相关生活质量（HRQoL）。这项横断面研究旨在使用两种HRQoL工具调查马来西亚AD患者的HRQoL得分，并确定患者HRQoL的预测因素。
在4家三级医院的门诊就诊期间招募AD患者的非正式照料者。使用代理评定的通用工具（EQ-5D-5L和EQ-VAS）评估患者的HRQoL，并通过结构化访谈利用特定疾病的工具（阿尔茨海默病生活质量量表[QoL-AD]）从照料者处获取AD患者的代理HRQoL得分。使用方差分析检验HRQoL得分与其他变量之间的差异。对这两种工具进行Pearson相关性检验，同时使用多变量线性回归模型确定AD患者HRQoL的预测因素。
通过代理评定，AD患者的平均EQ-5D-5L指数、EQ-VAS和QoL-AD得分分别为0.63±0.30、61.05±20.48和26.69±6.83。在相关性方面，EQ-5D与QoL-AD呈弱相关（r = 0.36，P <.01）。随着AD病情进展，EQ-5D指数和QoL-AD得分显著降低（P <.05）。此外，在以EQ-5D指数为变量的多变量模型中，认知功能下降、存在行为症状、女性照料者性别和未婚状态与患者较低的HRQoL相关（P <.05）。
AD患者的低HRQoL需要医疗保健提供者和利益相关者在优化资源分配和决策时予以关注。此类健康效用值在未来调查新干预措施或疾病修饰疗法成本效益的经济评估中很有用。
