ArticleMedical decision making : an international journal of the Society for Medical Decision Making2020
The Impact of Including Costs and Outcomes of Dementia in a Health Economic Model to Evaluate Lifestyle Interventions to Prevent Diabetes and Cardiovascular Disease.
Article in Medical decision making : an international journal of the Society for Medical Decision Making, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of hypertension prevention and modification on dementia burden: A systematic review of economic studies.The journal of prevention of Alzheimer's disease · 2025Pooled it
- Trial
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- Prevention of dementia using mobile phone applications (PRODEMOS) - a health-economic cost-utility analysis in people aged 55-75 years with low socio-economic status.The journal of prevention of Alzheimer's disease · 2026Article
- Alternative clinical trial designs to find a clinically important effect size of blood pressure-lowering on cognitive impairment and dementia.Journal of Alzheimer's disease : JAD · 2026Article
- Intensive weight loss intervention versus usual care in adults with obesity: a protocol for the LightCARE randomised clinical trial.BMJ open · 2025Article
- Assessing the value for money, from a policy maker perspective, of 24 randomised controlled trial designs for an online weight maintenance guided self-help intervention: an expected value of sample information analysis.International journal of obesity (2005) · 2025Article
- Public health economic modelling in evaluations of salt and/or alcohol policies: a systematic scoping review.BMC public health · 2025Article
- The potential impact of optimal blood pressure treatment intensity to reduce disparities in dementia between Black and White individuals.Journal of Alzheimer's disease : JAD · 2025Observational
- Cost-effectiveness analysis of two interventions to promote physical activity in a multiethnic population at high risk of diabetes: an economic evaluation of the 48-month PROPELS randomized controlled trial.BMJ open diabetes research & care · 2024Article
- Gene Therapy Versus Common Care for Eligible Individuals With Sickle Cell Disease in the United States : A Cost-Effectiveness Analysis.Annals of internal medicine · 2024Article
- The health, cost and equity impacts of restrictions on the advertisement of high fat, salt and sugar products across the transport for London network: a health economic modelling study.The international journal of behavioral nutrition and physical activity · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectivesEconomic evaluations of lifestyle interventions, which aim to prevent diabetes/cardiovascular disease (CVD), have not included dementia. Lifestyle interventions decrease dementia risk and extend life expectancy, leading to competing effects on health care costs. We aim to demonstrate the feasibility of including dementia in a public health cost-effectiveness analysis and quantify the overall impacts accounting for these competing effects.
methodsThe School for Public Health Research (SPHR) diabetes prevention model describes individuals' risk of type 2 diabetes, microvascular outcomes, CVD, congestive heart failure, cancer, osteoarthritis, depression, and mortality in England. In version 3.1, we adapted the model to include dementia using published data from primary care databases, health surveys, and trials of dementia to describe dementia incidence, diagnosis, and disease progression. We estimate the impact of dementia on lifetime costs and quality-adjusted life years (QALYs) gained of the National Health Service diabetes prevention program (NHS DPP) from an NHS/personal social services perspective with 3 scenarios: 1) no dementia, 2) dementia only, and 3) reduced dementia risk. Subgroup, parameter, and probabilistic sensitivity analyses were conducted.
resultsThe lifetime cost savings of the NHS DPP per patient were £145 in the no-dementia scenario, £121 in the dementia-only scenario, and £167 in the reduced dementia risk scenario. The QALY gains increased by 0.0006 in dementia only and 0.0134 in reduced dementia risk. Dementia did not alter the recommendation that the NHS/DPP is cost-effective.
conclusionsIncluding dementia into a model of lifestyle interventions was feasible but did not change policy recommendations or modify health economic outcomes. The impact on health economic outcomes was largest where a direct impact on dementia incidence was assumed, particularly in elderly populations.
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