Does Structured Exercise Improve Cognitive Impairment in People with Mild to Moderate Dementia? A Cost-Effectiveness Analysis from a Confirmatory Randomised Controlled Trial: The Dementia and Physical Activity (DAPA) Trial

Khan, Iftekhar; Petrou, Stavros; Khan, Kamran; Mistry, Dipesh; Lall, Ranjit; Sheehan, Bart; Lamb, Sarah E

doi:10.1007/s41669-018-0097-9

Cited by 14 publications

(26 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although our study showed good cost-effectiveness, a previous study 41) that investigated the cost-effectiveness of an exercise program for older adults who had already developed mild to moderate dementia reported that the program was not cost-effective. Two reasons might be considered for this.…”

Section: Discussioncontrasting

confidence: 55%

Cost-effectiveness Analysis of Combined Physical and Cognitive Exercises Programs Designed for Preventing Dementia among Community-dwelling Healthy Young-old Adults

et al. 2022

View full text Add to dashboard Cite

This study aims to estimate the cost-effectiveness of combined physical and cognitive programs designed to prevent community-dwelling healthy young-old adults from developing dementia. Methods: The analysis was conducted from a public healthcare and long-term care payer's perspective. Quality-adjusted life years (QALYs) and expenses for health services and long-term care services were described in terms of effectiveness and cost, respectively. A thousand community-dwelling healthy adults aged 65 years were generated through simulation and analyzed. The incremental cost-effectiveness ratio (ICER) of adults with preventive program intervention compared to those with nonintervention was simulated with a 10-year cycle Markov model. The data sources for the parameters to build the Markov models were selected with priority given to higher levels of evidence. The threshold for assessing cost-effectiveness was set as less than 5,000,000 Japanese yen/QALY. Results: The ICER was estimated as −5,740,083 Japanese yen (US$−57,400)/QALY. Conclusion: A program targeting community-dwelling healthy young-old adults could be cost-effective.

show abstract

Section: Discussioncontrasting

confidence: 55%

Cost-effectiveness Analysis of Combined Physical and Cognitive Exercises Programs Designed for Preventing Dementia among Community-dwelling Healthy Young-old Adults

et al. 2022

View full text Add to dashboard Cite

show abstract

“…1). Of the remaining 100 articles, 92 studies were further excluded mainly because of: (1) other publication formats such as conference papers, (2) participants without a formal diagnosis [8,[19][20][21][22], (3) a combination of different interventions [23][24][25][26][27][28], (4) no assessment of target outcome [29][30][31], (5) or institutionalized pwd [32][33][34][35][36]. Consequently, eight publications of seven trials with a total of 1135 participants were included in this review.…”

Section: Included Studiesmentioning

confidence: 99%

The effects of exercise programs on cognition, activities of daily living, and neuropsychiatric symptoms in community-dwelling people with dementia—a systematic review

et al. 2022

View full text Add to dashboard Cite

Background The prevalence of dementia is expected to increase dramatically. Due to a lack of pharmacological treatment options for people with dementia, non-pharmacological treatments such as exercise programs have been recommended to improve cognition, activities of daily living, and neuropsychiatric symptoms. However, inconsistent results have been reported across different trials, mainly because of the high heterogeneity of exercise modalities. Thus, this systematic review aims to answer the questions whether exercise programs improve cognition, activities of daily living as well as neuropsychiatric symptoms in community-dwelling people with dementia. Methods Eight databases were searched for articles published between 2016 and 2021 (ALOIS, CENTRAL, CINAHL, Embase, MEDLINE, PsycINFO, PubMed, Web of Science). Randomized controlled trials evaluating the effects of any type of physical activity on cognition, activities of daily living, or neuropsychiatric symptoms in community-dwelling people with a formal diagnosis of dementia were included in this systematic review. Two authors independently assessed eligibility and quality of the studies. The methodology was in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Results Eight publications covering seven trials were included in this review with the majority investigating either a combination of strength and aerobic exercise or aerobic exercise alone. This review revealed that there is no clear evidence for the beneficial effects of exercise on cognition. None of the included trials found an impact on activities of daily living. Although different randomized controlled trials reported inconsistent results, one trial indicated that especially aerobic exercise may improve neuropsychiatric symptoms. Conclusion Our systematic review did not confirm the impact of exercise on cognition and activities of daily living in community-dwelling people with dementia. The results suggested that aerobic exercise might be effective to reduce neuropsychiatric symptoms. Well-designed trials including only community-dwelling people with a formal diagnosis of dementia, large samples, long-term follow-ups, and detailed description of adherence to the intervention are needed to improve the scientific evidence on the best type of exercise modality. Trial registration PROSPERO, CRD42021246598.

show abstract

“…Иные данные получены в обзоре работ по эффективности психосоциальных мер вмешательства при ведении больных мягкой и умеренной БА. Мета-анализ исследований показал, что сочетание терапии ИХЭ с когнитивным тренингом замедляет прогрессирование деменции и рекомендуется для применения в клинической практике [103].…”

Section: значение когнитивного стиля жизни физических упражнений и пunclassified

Old Age Dementias: Factors Associated with Dementia Progression Rate. Part 2

Mikhailova¹

2020

Psychiatry

View full text Add to dashboard Cite

Background: steady progression of dementia is characterized with various rates, which specified clinical differentiation of dementias with rapid and slow increase of cognitive decline severity. The search for clinical factors, hypothetically responsible for differences in late age dementia progression rate, is one of the aspects of investigation of late age dementias.The objective was to generalize the results of the study of separate clinical factors effect on the differences in the late age dementia progression rate.Material and methods: papers in MEDLINE/PubMed bases from 1990 to 2020 were selected and analyzed according to the key words: “late age”, “dementia”, “progression rate”, “age of onset”, “non-cognitive disorders”, “nosomodifying therapy”, as well as relevant papers in the literature of the analyzed works.Conclusion: various parameters of the disease were studied as associated with dementia progression pattern. As regards part of them the results achieved compliance in recognition of association with dementia progression rate. As for the others this evidence is ambiguous. There are large discrepancies in attitudes to gender differences, while early age of disease onset, initially great intensity of neuropsychiatric disorders are concordantly admitted as associated with dementia rapid progression. The researchers are united with steady idea of nonlinear character of dementia progression at the stages of mild, moderate and severe dementia.The results of study of comorbidity are basically similar with regard to recognition of SFD influence, first of all, of arterial hypertension on dementia progression rate. The evidence of the efficacy of nosomodifying therapy, decelerating dementia progression, is unanimously considered an urgent problem. The development of new dementia pathogenesis concepts and the search for new therapy targets, are conducive to the solution of this problem. The results of the investigated direction of studies confirm the hypothesis of the fact that dementia progression occurs according to various pathogenetic mechanisms, which determine the dementia increasing rate. The management of patients with dementia in practice presupposes taking into account of various factors, influencing dementia progression rate, for planning of the volume and character of medical care.

show abstract

Does Structured Exercise Improve Cognitive Impairment in People with Mild to Moderate Dementia? A Cost-Effectiveness Analysis from a Confirmatory Randomised Controlled Trial: The Dementia and Physical Activity (DAPA) Trial

Abstract: Building on the clinical results of the trial, which showed that the structured exercise programme evaluated does not slow cognitive impairment in people with mild to moderate dementia, this economic evaluation shows that the programme is not cost effective.

Cited by 14 publications

References 23 publications

Cost-effectiveness Analysis of Combined Physical and Cognitive Exercises Programs Designed for Preventing Dementia among Community-dwelling Healthy Young-old Adults

Cost-effectiveness Analysis of Combined Physical and Cognitive Exercises Programs Designed for Preventing Dementia among Community-dwelling Healthy Young-old Adults

The effects of exercise programs on cognition, activities of daily living, and neuropsychiatric symptoms in community-dwelling people with dementia—a systematic review

Old Age Dementias: Factors Associated with Dementia Progression Rate. Part 2

Contact Info

Product

Resources

About