Introduction

Existing studies on the cost-effectiveness of multi-domain lifestyle prevention programs for dementia have been limited by explaining the effect of cardiovascular risk for the prevention strategies. This study aimed to incorporate the cardiovascular events and also link the cognitive outcomes to extrapolate long-term dementia risk using the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) trial.

Methods

Data were obtained from the FINGER trial, the Swedish National study on Aging and Care cohort, the Swedish national dementia registry, and recent literature. A Markov model with ten states (Figure 1) was applied to compare the prevention strategy with the standard care for the FINGER program, accounting for dementia, cardiovascular disease, and stroke. The model was projected over a 30-year time horizon.

Results

The prevention strategy was dominant for the FINGER prevention program. A total cost-saving of 69,083 SEK (equal to US$8,055) and a gain of 0.11 quality-adjusted life years (QALYs) per person. The prevention strategy was projected to prevent cases of dementia, as well as cardiovascular and stroke events.

Conclusions

The multi-domain lifestyle interventions in the FINGER trial are cost-effective. This prevention strategy has the potential to reduce not only dementia incidence but also cardiovascular and stroke events. This modeling framework for multidomain prevention programs could inform policymakers’ decisions on investments in dementia preventive care in Europe and other countries facing high and growing burdens of dementia.