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@ARTICLE{Brettschneider:274067,
      author       = {Brettschneider, Christian and Buczak-Stec, Elżbieta and
                      Luppa, Melanie and Zülke, Andrea and Michalowsky, Bernhard
                      and Rädke, Anika and Bauer, Alexander and Brütting,
                      Christine and Kosilek, Robert P and Zöllinger, Isabel and
                      Döhring, Juliane and Williamson, Martin and Wiese, Birgitt
                      and Hoffmann, Wolfgang and Frese, Thomas and Gensichen,
                      Jochen and Kaduszkiewicz, Hanna and Thyrian, Jochen René
                      and Riedel-Heller, Steffi G and König, Hans-Helmut},
      collaboration = {DE study group, AGEWELL.},
      title        = {{C}ost-effectiveness of a multicomponent intervention
                      against cognitive decline.},
      journal      = {Alzheimer's $\&$ dementia / Translational research $\&$
                      clinical interventions},
      volume       = {11},
      number       = {1},
      issn         = {2352-8737},
      address      = {Hoboken, NJ},
      publisher    = {Wiley},
      reportid     = {DZNE-2025-00048},
      pages        = {e70028},
      year         = {2025},
      abstract     = {The societal costs of dementia and cognitive decline are
                      substantial and likely to increase during the next decades
                      due to the increasing number of people in older age groups.
                      The aim of this multicenter cluster-randomized controlled
                      trial was to assess the cost-effectiveness of a multi-domain
                      intervention to prevent cognitive decline in older people
                      who are at risk for dementia.We used data from a
                      multi-centric, two-armed, cluster-randomized controlled
                      trial (AgeWell.de trial, ID: DRKS00013555). Eligible
                      participants with increased dementia risk at baseline
                      (Cardiovascular Risk Factors, Aging, and Incidence of
                      Dementia/CAIDE Dementia Risk Score ≥ 9), 60-77 years of
                      age, were recruited by their general practitioners, and
                      assigned randomly to a multi-domain lifestyle intervention
                      or general health advice. We performed a cost-effectiveness
                      analysis from the societal perspective. The time horizon was
                      2 years. Health care utilization was measured using the
                      'Questionnaire for Health-Related Resource Use in Older
                      Populations.' As effect measure, we used quality-adjusted
                      life-years (QALYs) based on the 5-level EQ-5D version
                      (EQ-5D-5L). We calculated the incremental cost-effectiveness
                      ratios (ICER) and cost-effectiveness acceptability curves
                      (CEAC) using the net-benefit approach. Exploratory analyses
                      considering women and the EQ visual analogue scale (EQ VAS)
                      were conducted.Data were available for 819 participants
                      (mean age 69.0 [standard deviation (SD)5-level EQ-5D version
                      4.9]); 378 were treated in the intervention group and 441 in
                      the control group. The participants in the intervention
                      group caused higher costs (+€445.88 [SD: €1,244.52]) and
                      gained additional effects (+0.026 QALY [SD: 0.020]) compared
                      to the participants in the control group (the difference was
                      statistically significant). The ICER was €17,149.23/QALY.
                      The CEAC showed that the probability of the intervention
                      being cost-effective was moderate, reaching $59\%$ at a
                      willingness-to-pay (WTP) of €50,000/QALY. The exploratory
                      analyses showed promising results, especially in the female
                      subsample.Considering aspects like the WTP and the limited
                      time horizon, the multi-domain intervention was
                      cost-effective compared to general health advice.The first
                      German randomized controlled trial (RCT) evaluating a
                      multicomponent approach against cognitive decline.We found a
                      favorable incremental cost-effectiveness ratio.The
                      probability of cost-effectiveness reached $78.6\%.Women$
                      could be an important target group.A longer time horizon is
                      needed.},
      keywords     = {RCT (Other) / cognitive decline (Other) /
                      cost‐effectiveness analysis (Other) / dementia (Other) /
                      multicomponent intervention (Other) / older individuals
                      (Other) / risk factors (Other)},
      cin          = {AG Michalowsky / AG Hoffmann / AG Thyrian},
      ddc          = {610},
      cid          = {I:(DE-2719)5000067 / I:(DE-2719)1510600 /
                      I:(DE-2719)1510800},
      pnm          = {353 - Clinical and Health Care Research (POF4-353)},
      pid          = {G:(DE-HGF)POF4-353},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39759949},
      pmc          = {pmc:PMC11696024},
      doi          = {10.1002/trc2.70028},
      url          = {https://pub.dzne.de/record/274067},
}