A systematic review of the cost-effectiveness of community and population interventions to reduce the modifiable risk factors for dementia

Walsh, Sebastian, Brain, Jacob, Mukadam, Naaheed, Anderson, Robert, Greene, Leanne, Govia, Ishtar, Kuhn, Isla, Anstey, Kaarin J., Knapp, Martin ORCID: 0000-0003-1427-0215, Stephan, Blossom C.M. and Brayne, Carol (2022) A systematic review of the cost-effectiveness of community and population interventions to reduce the modifiable risk factors for dementia. Maturitas, 166. 104 - 116. ISSN 0378-5122

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Abstract

Dementia is a leading global cause of morbidity and mortality. Evidence suggests that tackling modifiable lifecourse risk factors could prevent or delay a significant proportion of cases. Population- and community-based approaches change societal conditions such that everyone across a given community is more likely to live more healthily. We systematically reviewed economic studies of population- and community-based interventions to reduce modifiable lifecourse risk factors for dementia. We searched Medline, EMBASE, Web of Science, CINAHL, PsycInfo, Scopus, Econlit, ERIC, the British Education Index, and Google, on 03/03/2022. We included cost-effectiveness, cost-benefit, and cost-utility studies, provided that the direct outcome of the intervention was a modifiable risk factor for dementia, and was measured empirically. Quality appraisal was completed using the Consensus on Health Economic Criteria checklist. A narrative synthesis was performed. We included 45 studies, from 22,749 records identified. Included studies targeted smoking (n = 15), education (n = 10), physical inactivity (n = 9), obesity (n = 5), air pollution (n = 2), traumatic brain injury (n = 1), and multiple risk factors (n = 3). Intervention designs included changing the physical/food environment (n = 13), mass media programmes (n = 11), reducing financial barriers or increasing resources (n = 10), whole-community approaches (n = 6), and legislative change (n = 3). Overall, interventions were highly cost-effective and/or cost-saving, particularly those targeting smoking, educational attainment, and physical inactivity. Effects were observed in high- (e.g. USA and UK) and low- and middle-income (e.g. Mexico, Tanzania, Thailand) countries. Further research into the direct effects of targeting these risk factors on future dementia prevalence will have important economic, social and policy implications.

Item Type:	Article
Official URL:	https://www.maturitas.org/
Additional Information:	© 2022 The Author(s)
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Date Deposited:	06 Oct 2022 09:24
Last Modified:	12 Dec 2024 03:19
URI:	http://eprints.lse.ac.uk/id/eprint/116915

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