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The Journal of Prevention of Alzheimer s Disease
Article . 2021 . Peer-reviewed
License: CC BY NC ND
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Cost-Effectiveness of Dementia Prevention Interventions

Authors: S. Bourke; Nicolas Cherbuin; L. Zheng; L. Zheng; Ian McRae; Kaarin J. Anstey; Kaarin J. Anstey;

Cost-Effectiveness of Dementia Prevention Interventions

Abstract

Assessment of cost-effectiveness of interventions to address modifiable risk factors associated with dementia requires estimates of long-term impacts of these interventions which are rarely directly available and must be estimated using a range of assumptions.To test the cost-effectiveness of dementia prevention measures using a methodology which transparently addresses the many assumptions required to use data from short-term studies, and which readily incorporates sensitivity analyses.We explore an approach to estimating cost-effective prices which uses aggregate data including estimated lifetime costs of dementia, both financial and quality of life, and incorporates a range of assumptions regarding sustainability of short- term gains and other parameters.The approach is addressed in the context of the theoretical reduction in a range of risk factors, and in the context of a specific small-scale trial of an internet-based intervention augmented with diet and physical activity consultations.The principal outcomes were prices per unit of interventions at which interventions were cost-effective or cost-saving.Taking a societal perspective, a notional intervention reducing a range of dementia risk-factors by 5% was cost-effective at $A460 per person with higher risk groups at $2,148 per person. The on-line program costing $825 per person was cost-effective at $1,850 per person even if program effect diminished by 75% over time.Interventions to address risk factors for dementia are likely to be cost-effective if appropriately designed, but confirmation of this conclusion requires longer term follow-up of trials to measure the impact and sustainability of short-term gains.

Country
Australia
Keywords

Comparative Effectiveness Research, Aging, 330, Cost-Benefit Analysis, 5202 Biological Psychology, Clinical Trials and Supportive Activities, 610, 32 Biomedical and Clinical Sciences, Neurodegenerative, anzsrc-for: 52 Psychology, anzsrc-for: 32 Biomedical and Clinical Sciences, Clinical Research, Behavioral and Social Science, 5204 Cognitive and Computational Psychology, Acquired Cognitive Impairment, risk factors, Humans, cost-effectiveness, interventions, Exercise, Prevention, Neurosciences, Health Care Costs, Health Services, sustainability, Brain Disorders, Cost Effectiveness Research, anzsrc-for: 5204 Cognitive and Computational Psychology, 52 Psychology, 3209 Neurosciences, Quality of Life, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, anzsrc-for: 3209 Neurosciences, Dementia, anzsrc-for: 5202 Biological Psychology, Delivery of Health Care

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    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    8
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Average
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
8
Top 10%
Average
Top 10%
Green
hybrid