Health-Related Quality of Life in Patients With Alzheimer Disease in Malaysia: Evidence from EQ-5D and QOL-AD

Abstract

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.