@article{cf79f4ff99b347d0ab5fe1a69a53a940,
title = "Challenges and recommendations for the health-economic evaluation of primary prevention programmes for dementia",
abstract = "Objective: We aimed to review health-economic evaluations of (hypothetical) intervention programmes for the primary prevention of dementia, and highlight challenges and provide recommendations for future research to estimate its cost-effectiveness. Methods: We searched the databases PubMed, MODEM, CEA and NHS for publications on the cost-consequence, -effectiveness, -utility or -benefit analysis of (hypothetical) interventions to reduce the risk of developing dementia for persons without dementia, and described the study characteristics. Results: Three publications described the evaluation of a hypothetical risk reduction due to physical activity or a multidomain intervention programme. Two studies reported a reduction of care costs. One study yielded two scenarios of increased care costs and one scenario of reduced care costs. Only one study reported the impact in QALY terms, and found a QALY gain. Conclusion: A few studies have evaluated a hypothetical multidomain prevention intervention, and reported that primary dementia prevention is potentially cost-saving or cost-effective. Various challenges remain to evaluate the health-economic impact of prevention interventions, including extrapolation of short-term trial effects, care costs in the dementia-free and life years gained, and accurate representation of usual care. We recommend extensive sensitivity analyses to examine the impact of assumptions regarding these aspects on the outcomes of cost-effectiveness studies.",
keywords = "ALZHEIMERS-DISEASE, CARE, COGNITIVE DECLINE, COST-EFFECTIVENESS, Costs, DISEASE-MODIFYING TREATMENT, IMPACT, INTERVENTIONS, OLDER-ADULTS, RISK-FACTORS, UTILITY, cognitive disorder, dementia, economic evaluation, multidomain lifestyle intervention, prevention",
author = "Ron Handels and Anders Wimo",
note = "Funding Information: RH: related to this research: none; outside this research: personal fees from Nutricia Medical Nutrition (consultant), personal fees from Piramal (consultant), grants from CTMM Grant 02 N-101. Funding Information: This is an EU Joint Programme - Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND - www.jpnd.eu: Finland, Suomen Akatemia (Academy of Finland, 291803); France, L'Agence Nationale de la Recherche (The French National Research Agency, ANR-14-JPPS-0001-02); Germany, Bundesministerium f?r Bildung und Forschung (BMBF) (The Federal Ministry of Education and Research, FKZ01ED1509); Sweden, Vetenskapsr?det (VR) (Swedish Research Council, 529-2014-7503), The Netherlands, ZonMw (The Netherlands Organisation for Health Research and Development, 733051041). This is an EU Joint Programme - Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND - www.jpnd.eu: Finland, Suomen Akatemia (Academy of Finland, 291803); France, L'Agence Nationale de la Recherche (The French National Research Agency, ANR-14-JPPS-0001-02); Germany, Bundesministerium f?r Bildung und Forschung (BMBF) (The Federal Ministry of Education and Research, FKZ01ED1509); Sweden, Vetenskapsr?det (VR) (Swedish Research Council, 529-2014-7503), The Netherlands, ZonMw (The Netherlands Organisation for Health Research and Development, 733051041). Funding Information: This is an EU Joint Programme - Neurodegenerative Disease Research (JPND) project. The project is supported through the following funding organisations under the aegis of JPND - www.jpnd.eu: Finland, Suomen Akatemia (Academy of Finland, 291803); France, L{\textquoteright}Agence Nationale de la Recherche (The French National Research Agency, ANR-14-JPPS-0001-02); Germany, Bundesministerium fu€r Bildung und Forschung (BMBF) (The Federal Ministry of Education and Research, FKZ01ED1509); Sweden, Vetenskapsra°det (VR) (Swedish Research Council, 529-2014-7503), The Netherlands, ZonMw (The Netherlands Organisation for Health Research and Development, 733051041). Publisher Copyright: {\textcopyright} 2017, {\textcopyright} 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.",
year = "2019",
month = jan,
day = "2",
doi = "10.1080/13607863.2017.1390730",
language = "English",
volume = "23",
pages = "53--59",
journal = "Aging & Mental Health",
issn = "1360-7863",
publisher = "Routledge/Taylor & Francis Group",
number = "1",
}