Factors associated with patient activation in an older adult population with functional difficulties

Patient Educ Couns. 2016 Aug;99(8):1421-6. doi: 10.1016/j.pec.2016.03.011. Epub 2016 Mar 17.


Objective: Patient activation, the patient's knowledge, skill, and confidence to manage his or her health, is an important indicator of future health and use of health care resources. Understanding factors associated with patient activation in an older population with functional difficulties may inform care in this population. This study aimed to determine whether patient activation is associated with depression, chronic conditions, family support, difficulties with activities of daily living (ADLs) and instrumental activities of daily living (IADLs), hospitalizations, education, and financial strain.

Methods: (N=277), We administered surveys measuring patient activation, financial strain, depressive symptoms, family support, and chronic conditions to an older adult population. We tested association through multivariate linear regressions controlling for race, sex, and age.

Results: Patient activation is significantly (p<0.05), positively associated with family support and self-rated overall health, and significantly (p<0.05), negatively associated with depressive symptoms and difficulties with ADLs and IADLs. We found no association between patient activation and financial stress, hospitalizations, and education.

Conclusions: Older age, depressive symptoms, and difficulties with ADLs and IADLs were associated with decreased patient activation.

Practice implications: Developing interventions tailored to older adults' level of patient activation has the potential to improve outcomes for this population.

Keywords: Activities of daily living; Functional difficulties; Instrumental; Older adults; Patient activation; Patient activation measure.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Activities of Daily Living*
  • Aged
  • Aged, 80 and over
  • Chronic Disease / psychology*
  • Chronic Disease / therapy
  • Cross-Sectional Studies
  • Depression / psychology*
  • Disabled Persons / statistics & numerical data*
  • Female
  • Geriatric Assessment
  • Health Status*
  • Health Surveys
  • Humans
  • Male
  • Patient Participation*
  • Quality of Life
  • Social Support
  • Socioeconomic Factors
  • Surveys and Questionnaires