Understanding the Impact of Patient Activation Levels on Alzheimer’s Caregiving in China
Author(s)
Neeyor Bose, PhD1, Maria Choufany, MSc2, Nikoletta Sternbach, BA3, Amanda Woo, PhD4.
1Oracle Life Science, Singapore, Singapore, 2Oracle Life Science, Paris, France, 3Oracle Life Science, New York, NY, USA, 4Oracle Life Sciences Singapore, Singapore, Singapore.
1Oracle Life Science, Singapore, Singapore, 2Oracle Life Science, Paris, France, 3Oracle Life Science, New York, NY, USA, 4Oracle Life Sciences Singapore, Singapore, Singapore.
OBJECTIVES: Alzheimer’s disease presents significant burden in China and impact of the disease is most keenly felt by informal caregivers. The Patient Activation Measure (PAM) assesses an individual's capacity for health self-management, encompassing knowledge, skills, and confidence, and is associated with positive health outcomes. However, the influence of caregiver PAM levels on the reduction of Alzheimer’s caregiver burden in China is unknown. This study compares the burden experienced by caregivers of Alzheimer’s patients grouped by their PAM levels.
METHODS: Data from China 2017 and 2020 National Health and Wellness Survey, an internet-based, cross-sectional survey of adults (≥18 years) was used. Caregivers of adult relative living with Alzheimer Disease. Comparisons of caregivers’ PAM levels (higher levels=higher activation), their socio-demographic and patient-reported outcomes [SF-12, Work Productivity and Activity Impairment (WPAI), Caregiver Reaction Assessment Scale (CRA), Patient Health Questionnaire-9 (PHQ-9)] were conducted using chi-square and ANOVA tests . P-values <0.05, two-tailed, were statistically significant.
RESULTS: Among n=324 caregivers, 6.79% (n=22) were PAM1, 15.12% (n=49) PAM2, 55.25% (n=179) PAM3; and 14.51% (n=47) PAM4. PAM1 had the highest proportions for moderate-severe depression (PHQ-9 score >=10) (55.55%; PAM2: 40.82%; PAM3: 25.14%; PAM4: 34.04%) and visits to healthcare providers (100%; 83.67%; 77.09%; 87.23%). PAM3 reported higher mean mental SF-12 scores compared to PAM1 (46.91 vs 39.86; p<0.05). For WPAI, PAM4 reported lower activity impairment compared to PAM1 (30.85% vs 53.18%; p<0.05). Using the CRA scale, PAM4 reported higher self-esteem though they experienced higher disrupted schedule compared to PAM1 (p<0.05). PAM4 were more likely to care for a patient who received treatment for AD vs PAM1 (76.60% vs 54.55%; p<0.05).
CONCLUSIONS: Study findings show that caregivers with higher PAM scores had higher quality of life and self-esteem, increased work productivity, lower depression and lower healthcare utilization. This presents an opportunity for the healthcare system to improve patient activation in caregivers in China.
METHODS: Data from China 2017 and 2020 National Health and Wellness Survey, an internet-based, cross-sectional survey of adults (≥18 years) was used. Caregivers of adult relative living with Alzheimer Disease. Comparisons of caregivers’ PAM levels (higher levels=higher activation), their socio-demographic and patient-reported outcomes [SF-12, Work Productivity and Activity Impairment (WPAI), Caregiver Reaction Assessment Scale (CRA), Patient Health Questionnaire-9 (PHQ-9)] were conducted using chi-square and ANOVA tests . P-values <0.05, two-tailed, were statistically significant.
RESULTS: Among n=324 caregivers, 6.79% (n=22) were PAM1, 15.12% (n=49) PAM2, 55.25% (n=179) PAM3; and 14.51% (n=47) PAM4. PAM1 had the highest proportions for moderate-severe depression (PHQ-9 score >=10) (55.55%; PAM2: 40.82%; PAM3: 25.14%; PAM4: 34.04%) and visits to healthcare providers (100%; 83.67%; 77.09%; 87.23%). PAM3 reported higher mean mental SF-12 scores compared to PAM1 (46.91 vs 39.86; p<0.05). For WPAI, PAM4 reported lower activity impairment compared to PAM1 (30.85% vs 53.18%; p<0.05). Using the CRA scale, PAM4 reported higher self-esteem though they experienced higher disrupted schedule compared to PAM1 (p<0.05). PAM4 were more likely to care for a patient who received treatment for AD vs PAM1 (76.60% vs 54.55%; p<0.05).
CONCLUSIONS: Study findings show that caregivers with higher PAM scores had higher quality of life and self-esteem, increased work productivity, lower depression and lower healthcare utilization. This presents an opportunity for the healthcare system to improve patient activation in caregivers in China.
Conference/Value in Health Info
2025-09, ISPOR Real-World Evidence Summit 2025, Tokyo, Japan
Value in Health Regional, Volume 49S (September 2025)
Code
RWD314
Topic Subcategory
Reproducibility & Replicability
Disease
SDC: Neurological Disorders