Objective To analyze the level and influencing factors of productive engagement in patients with mild-to-moderate Alzheimer′s disease,in order to provide guidance for developing clinical interventions to improve their level of productive engagement. Methods From June 2024 to August 2025, a total of 212 patients with mild-to-moderate Alzheimer′s disease were selected through convenience sampling method, then they were investigated by using a general information questionnaire, the Stigma Scale for Chronic Illness 8-items (SSCI-8), the Chinese People′s Social Support Scale (CPSSS) and the Productive Engagement Scale (PES). Results The participants′ total score of PES was 36.00(18.00,36.00)points. Multiple linear regression analysis showed that, age, educational background, the number of chronic comorbidities, stigma and social support were influencing factors of productive engagement in patients with mild-to-moderate Alzheimer′s disease(all P<0.05). Conclusion The productive engagement in patients with mild-to-moderate Alzheimer′s disease is at a moderate to low level. Clinical medical staff should provide targeted interventions according to its influencing factors, so as to improve their productive engagement.