Cost-effectiveness of a multicomponent intervention against cognitive decline.

Area of Science:

• Gerontology
• Public Health
• Health Economics

Background:

• Societal costs of dementia and cognitive decline are substantial and rising.
• Older populations are increasing, exacerbating the burden of cognitive impairment.
• Preventive strategies are crucial to mitigate future healthcare demands.

Purpose of the Study:

• To assess the cost-effectiveness of a multi-domain intervention for preventing cognitive decline in at-risk older individuals.
• To compare a multi-domain lifestyle intervention against general health advice.
• To evaluate the economic value of a novel approach to dementia prevention.

Main Methods:

• A multicenter, cluster-randomized controlled trial (AgeWell.de) involving 819 participants (age 60-77) at increased dementia risk.
• Cost-effectiveness analysis from a societal perspective over a 2-year time horizon.
• Measurement of health care utilization and quality-adjusted life-years (QALYs) using EQ-5D-5L.

Main Results:

• The intervention group incurred higher costs (+€445.88) but gained additional QALYs (+0.026) compared to the control group.
• The incremental cost-effectiveness ratio (ICER) was €17,149.23 per QALY.
• The probability of cost-effectiveness reached 59% at a willingness-to-pay of €50,000/QALY, with promising results in women.

Conclusions:

• The multi-domain intervention is cost-effective compared to general health advice, considering willingness-to-pay and the study's time horizon.
• The intervention shows potential for reducing the societal burden of cognitive decline.
• Further research with a longer time horizon is warranted to fully ascertain long-term benefits.