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Cost-Effectiveness of Dementia Prevention Interventions

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The Journal of Prevention of Alzheimer's Disease Aims and scope Submit manuscript

Abstract

Background

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.

Objectives

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.

Design

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.

Setting

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. MEASUREMENTS: The principal outcomes were prices per unit of interventions at which interventions were cost-effective or cost-saving.

Results

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.

Conclusions

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.

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Acknowledgements

We acknowledge the ARC Centre of Excellence in Population Ageing Research.

Funding

This research was undertaken as part of the Centre for Research Excellence in Cognitive Health, which was funded by the National Health and Medical Research Council grant #1100579. Anstey is funded by NHMRC Fellowship #1102694, Zheng is part supported by the NHMRC Dementia Centre for Research Collaboration. The funders had no role in the design and conduct of this study; in the analysis and interpretation of the data; in the preparation of the manuscript; or in the review or approval of the manuscript.

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Authors and Affiliations

  1. Centre for Research on Ageing Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, ACT, 2600, Australia

    Ian McRae & N. Cherbuin

  2. Neuroscience Research Australia, Margarete Ainsworth Building, Barker Street, Randwick, Sydney, NSW, Australia

    L. Zheng & K. J. Anstey

  3. Department of Health Services Research and Policy, Research School of Population Health, The Australian National University, Canberra, ACT, Australia

    S. Bourke

  4. Ageing Futures Institute, School of Psychology, University of New South Wales, Sydney, NSW, Australia

    L. Zheng & K. J. Anstey

Authors
  1. Ian McRae
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  2. L. Zheng
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  3. S. Bourke
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  4. N. Cherbuin
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  5. K. J. Anstey
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Corresponding author

Correspondence to Ian McRae.

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The authors followed the ethical guidelines of the Journal for this manuscript.

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Conflict of Interest

Dr McRae, Dr Zheng, Dr Bourke, and Professor Cherbuin declare that they have no conflict of interest. Professor Anstey reports personal fees from StaySharp, outside the submitted work.

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McRae, I., Zheng, L., Bourke, S. et al. Cost-Effectiveness of Dementia Prevention Interventions. J Prev Alzheimers Dis 8, 210–217 (2021). https://doi.org/10.14283/jpad.2020.71

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  • DOI: https://doi.org/10.14283/jpad.2020.71

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