Presentation (CTI)

OBJECTIVES: To assess health-related quality of life (HRQoL) in patients with mild cognitive impairment (MCI) or dementia and their caregivers in Thailand, using both self-reported and proxy-reported utility scores.
METHODS: A cross-sectional study was conducted at five super-tertiary university hospitals across geriatrics, neurology, and psychiatry departments. A total of 289 patients (MCI to severe dementia) and 278 primary caregivers were enrolled. EQ-5D-5L utility scores were obtained via self-report (patients with MCI or mild dementia only) and proxy-report (caregivers of patients across all severity levels). Caregivers also reported their own utility scores.
RESULTS: Most patients were female (73.5%) with a mean age of 78.4 years. Alzheimer’s disease was the predominant diagnosis. Utility scores from patient self-reports were high (mean 0.91 for MCI; 0.93 for mild dementia), while proxy-reported scores declined significantly with increasing disease severity (from 0.87 in MCI to 0.33 in severe dementia), suggesting greater sensitivity to clinical progression. Mean utility scores were 0.92 (self-reported) and 0.69 (proxy-reported). Caregivers’ utility averaged 0.92 but decreased with increasing patient severity. The relatively high scores may reflect burden-sharing through multiple or paid caregivers. Problems in EQ-5D-5L dimensions, especially mobility, self-care, and usual activities, increased with dementia severity in both groups.
CONCLUSIONS: Dementia severity is inversely associated with utility scores in both patients and caregivers. Proxy-reported utility may better reflect the true health status and care burden than self-reported measures. The utility values generated from this study can serve as key inputs for health technology assessment (HTA) to support policy development under Universal Health Coverage (UHC), particularly for early screening and diagnosis, strengthening caregiver support systems, and planning long-term care services.