Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program

Anders Wimo; Ron Handels; Riitta Antikainen; Maria Eriksdotter; Linus Jönsson; Martin Knapp; Jenni Kulmala; Tiina Laatikainen; Jenni Lehtisalo; Markku Peltonen; Anders Sköldunger; Hilkka Soininen; Alina Solomon; Timo Strandberg; Jaakko Tuomilehto; Tiia Ngandu; Miia Kivipelto

doi:10.1002/alz.12698

Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program

Anders Wimo^*
, Ron Handels
, Riitta Antikainen
, Maria Eriksdotter
, Linus Jönsson
, Martin Knapp
, Jenni Kulmala
, Tiina Laatikainen
, Jenni Lehtisalo
, Markku Peltonen
, Anders Sköldunger
, Hilkka Soininen
, Alina Solomon
, Timo Strandberg
, Jaakko Tuomilehto
, Tiia Ngandu
, Miia Kivipelto

^*Corresponding author for this work

Research output: Contribution to journal › Article › Scientific › peer-review

53 Citations (Scopus)

36 Downloads (Pure)

Abstract

Introduction: The aim of this study was to estimate the potential cost-effectiveness of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) program. Methods: A life-time Markov model with societal perspective, simulating a cohort of people at risk of dementia reflecting usual care and the FINGER program. Results: Costs were 1,653,275 and 1,635,346 SEK and quality-adjusted life years (QALYs) were 8.636 and 8.679 for usual care and the FINGER program, respectively, resulting in savings of 16,928 SEK (2023 US$) and 0.043 QALY gains per person, supporting extended dominance for the FINGER program. A total of 1623 dementia cases were avoided with 0.17 fewer person-years living with dementia. The sensitivity analysis confirmed the conclusions in most scenarios. Discussion: The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia. Results at the individual level are rather modest, but the societal benefits can be substantial because of the large potential target population.

Original language	English
Pages (from-to)	999-1008
Number of pages	10
Journal	Alzheimer's and Dementia
Volume	19
Issue number	3
Early online date	Jul 2022
DOIs	https://doi.org/10.1002/alz.12698
Publication status	Published - 2023
Publication type	A1 Journal article-refereed

Funding

A.W. paid to institution: EU project JPND: MIND‐AD, RH paid to institution: MIND‐AD (EU JPND grant 2017‐2018). R.A. paid to institution: Data collected at the study site (material and salaries for FINGER study) was supported by state (Finland) research funding. M.E. paid to institution: Funding from Swedish Associations of Local authorities and regions. A.S. paid to institution: Research grants from Academy of Finland, European. T.N. paid to institution: Grants from JPND (EURO‐FINGERS), and Juho Vainio Foundation, Finland. M.K. paid to institution: EU Joint Programme ‐ Neurodegenerative Disease Research (JPND), Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, The Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm, Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, The Swedish Associations of Local Authorities and Regions, Swedish Government (Swedish Ministry of Health and Social Affairs). L.J., M.K., J.K., T.L., J.L., M.P., A.S., H.S., T.S., and J.T. have nothing to declare. Author disclosures are available in the supporting information. The work was conducted as part of the EU Joint Programme – Neurodegenerative Disease Research (JPND) projects MIND‐AD and EURO‐FINGERS. The project is additionally supported by Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm (ALF, NSV), Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, Academy of Finland (grants 317465, 287490, 294061, 319318), Finnish Social Insurance Institution, Finnish Ministry of Education and Culture, Juho Vainio Foundation, Finland, Alzheimer's Research and Prevention Foundation, US. The authors are grateful to the FINGER study team and participants. The authors are grateful to the Swedish Dementia Registry (SveDem, www.svedem.se ) for providing data for this study. We thank all patients, caregivers, reporting units, and coordinators in SveDem as well as SveDem steering committee members. SveDem is supported financially by the Swedish Associations of Local Authorities and Regions.

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

Keywords

cost effectiveness
costs
dementia
FINGER
health economic simulation
prevention

Publication forum classification

Publication forum level 2

ASJC Scopus subject areas

Epidemiology
Health Policy
Developmental Neuroscience
Clinical Neurology
Geriatrics and Gerontology
Cellular and Molecular Neuroscience
Psychiatry and Mental health

Access to Document

10.1002/alz.12698Licence: CC BY-NC-ND

Alzheimer s Dementia - 2022 - Wimo - Dementia prevention The potential long%u2010term cost%u2010effectiveness of the FINGERFinal published version, 324 KBLicence: CC BY-NC-ND

https://urn.fi/URN:NBN:fi:tuni-202208036177Licence: CC BY-NC-ND

Cite this

Wimo, A., Handels, R., Antikainen, R., Eriksdotter, M., Jönsson, L., Knapp, M., Kulmala, J., Laatikainen, T., Lehtisalo, J., Peltonen, M., Sköldunger, A., Soininen, H., Solomon, A., Strandberg, T., Tuomilehto, J., Ngandu, T., & Kivipelto, M. (2023). Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program. Alzheimer's and Dementia, 19(3), 999-1008. https://doi.org/10.1002/alz.12698

@article{c3127bc65b054acfa12182f3bd96fdf7,

title = "Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program",

abstract = "Introduction: The aim of this study was to estimate the potential cost-effectiveness of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) program. Methods: A life-time Markov model with societal perspective, simulating a cohort of people at risk of dementia reflecting usual care and the FINGER program. Results: Costs were 1,653,275 and 1,635,346 SEK and quality-adjusted life years (QALYs) were 8.636 and 8.679 for usual care and the FINGER program, respectively, resulting in savings of 16,928 SEK (2023 US\$) and 0.043 QALY gains per person, supporting extended dominance for the FINGER program. A total of 1623 dementia cases were avoided with 0.17 fewer person-years living with dementia. The sensitivity analysis confirmed the conclusions in most scenarios. Discussion: The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia. Results at the individual level are rather modest, but the societal benefits can be substantial because of the large potential target population.",

keywords = "cost effectiveness, costs, dementia, FINGER, health economic simulation, prevention",

author = "Anders Wimo and Ron Handels and Riitta Antikainen and Maria Eriksdotter and Linus J{\"o}nsson and Martin Knapp and Jenni Kulmala and Tiina Laatikainen and Jenni Lehtisalo and Markku Peltonen and Anders Sk{\"o}ldunger and Hilkka Soininen and Alina Solomon and Timo Strandberg and Jaakko Tuomilehto and Tiia Ngandu and Miia Kivipelto",

note = "Funding Information: A.W. paid to institution: EU project JPND: MIND‐AD, RH paid to institution: MIND‐AD (EU JPND grant 2017‐2018). R.A. paid to institution: Data collected at the study site (material and salaries for FINGER study) was supported by state (Finland) research funding. M.E. paid to institution: Funding from Swedish Associations of Local authorities and regions. A.S. paid to institution: Research grants from Academy of Finland, European. T.N. paid to institution: Grants from JPND (EURO‐FINGERS), and Juho Vainio Foundation, Finland. M.K. paid to institution: EU Joint Programme ‐ Neurodegenerative Disease Research (JPND), Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, The Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm, Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, The Swedish Associations of Local Authorities and Regions, Swedish Government (Swedish Ministry of Health and Social Affairs). L.J., M.K., J.K., T.L., J.L., M.P., A.S., H.S., T.S., and J.T. have nothing to declare. Author disclosures are available in the supporting information. Funding Information: The work was conducted as part of the EU Joint Programme {\textendash} Neurodegenerative Disease Research (JPND) projects MIND‐AD and EURO‐FINGERS. The project is additionally supported by Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm (ALF, NSV), Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, Academy of Finland (grants 317465, 287490, 294061, 319318), Finnish Social Insurance Institution, Finnish Ministry of Education and Culture, Juho Vainio Foundation, Finland, Alzheimer's Research and Prevention Foundation, US. The authors are grateful to the FINGER study team and participants. The authors are grateful to the Swedish Dementia Registry (SveDem, www.svedem.se ) for providing data for this study. We thank all patients, caregivers, reporting units, and coordinators in SveDem as well as SveDem steering committee members. SveDem is supported financially by the Swedish Associations of Local Authorities and Regions. Publisher Copyright: {\textcopyright} 2022 The Authors. Alzheimer's \& Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.",

year = "2023",

doi = "10.1002/alz.12698",

language = "English",

volume = "19",

pages = "999--1008",

journal = "Alzheimer's and Dementia",

issn = "1552-5260",

publisher = "John Wiley and Sons Inc",

number = "3",

}

Wimo, A, Handels, R, Antikainen, R, Eriksdotter, M, Jönsson, L, Knapp, M, Kulmala, J, Laatikainen, T, Lehtisalo, J, Peltonen, M, Sköldunger, A, Soininen, H, Solomon, A, Strandberg, T, Tuomilehto, J, Ngandu, T & Kivipelto, M 2023, 'Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program', Alzheimer's and Dementia, vol. 19, no. 3, pp. 999-1008. https://doi.org/10.1002/alz.12698

TY - JOUR

T1 - Dementia prevention

T2 - The potential long-term cost-effectiveness of the FINGER prevention program

AU - Wimo, Anders

AU - Handels, Ron

AU - Antikainen, Riitta

AU - Eriksdotter, Maria

AU - Jönsson, Linus

AU - Knapp, Martin

AU - Kulmala, Jenni

AU - Laatikainen, Tiina

AU - Lehtisalo, Jenni

AU - Peltonen, Markku

AU - Sköldunger, Anders

AU - Soininen, Hilkka

AU - Solomon, Alina

AU - Strandberg, Timo

AU - Tuomilehto, Jaakko

AU - Ngandu, Tiia

AU - Kivipelto, Miia

N1 - Funding Information: A.W. paid to institution: EU project JPND: MIND‐AD, RH paid to institution: MIND‐AD (EU JPND grant 2017‐2018). R.A. paid to institution: Data collected at the study site (material and salaries for FINGER study) was supported by state (Finland) research funding. M.E. paid to institution: Funding from Swedish Associations of Local authorities and regions. A.S. paid to institution: Research grants from Academy of Finland, European. T.N. paid to institution: Grants from JPND (EURO‐FINGERS), and Juho Vainio Foundation, Finland. M.K. paid to institution: EU Joint Programme ‐ Neurodegenerative Disease Research (JPND), Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, The Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm, Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, The Swedish Associations of Local Authorities and Regions, Swedish Government (Swedish Ministry of Health and Social Affairs). L.J., M.K., J.K., T.L., J.L., M.P., A.S., H.S., T.S., and J.T. have nothing to declare. Author disclosures are available in the supporting information. Funding Information: The work was conducted as part of the EU Joint Programme – Neurodegenerative Disease Research (JPND) projects MIND‐AD and EURO‐FINGERS. The project is additionally supported by Alzheimerfonden, Center for Innovative Medicine (CIMED) at Karolinska Institutet South Campus, the Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse, Region Stockholm (ALF, NSV), Stiftelsen Stockholms sjukhem, Swedish Research Council for Health Working Life and Welfare (FORTE), and European Research Council grant 804371, Academy of Finland (grants 317465, 287490, 294061, 319318), Finnish Social Insurance Institution, Finnish Ministry of Education and Culture, Juho Vainio Foundation, Finland, Alzheimer's Research and Prevention Foundation, US. The authors are grateful to the FINGER study team and participants. The authors are grateful to the Swedish Dementia Registry (SveDem, www.svedem.se ) for providing data for this study. We thank all patients, caregivers, reporting units, and coordinators in SveDem as well as SveDem steering committee members. SveDem is supported financially by the Swedish Associations of Local Authorities and Regions. Publisher Copyright: © 2022 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.

PY - 2023

Y1 - 2023

N2 - Introduction: The aim of this study was to estimate the potential cost-effectiveness of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) program. Methods: A life-time Markov model with societal perspective, simulating a cohort of people at risk of dementia reflecting usual care and the FINGER program. Results: Costs were 1,653,275 and 1,635,346 SEK and quality-adjusted life years (QALYs) were 8.636 and 8.679 for usual care and the FINGER program, respectively, resulting in savings of 16,928 SEK (2023 US$) and 0.043 QALY gains per person, supporting extended dominance for the FINGER program. A total of 1623 dementia cases were avoided with 0.17 fewer person-years living with dementia. The sensitivity analysis confirmed the conclusions in most scenarios. Discussion: The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia. Results at the individual level are rather modest, but the societal benefits can be substantial because of the large potential target population.

AB - Introduction: The aim of this study was to estimate the potential cost-effectiveness of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) program. Methods: A life-time Markov model with societal perspective, simulating a cohort of people at risk of dementia reflecting usual care and the FINGER program. Results: Costs were 1,653,275 and 1,635,346 SEK and quality-adjusted life years (QALYs) were 8.636 and 8.679 for usual care and the FINGER program, respectively, resulting in savings of 16,928 SEK (2023 US$) and 0.043 QALY gains per person, supporting extended dominance for the FINGER program. A total of 1623 dementia cases were avoided with 0.17 fewer person-years living with dementia. The sensitivity analysis confirmed the conclusions in most scenarios. Discussion: The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia. Results at the individual level are rather modest, but the societal benefits can be substantial because of the large potential target population.

KW - cost effectiveness

KW - costs

KW - dementia

KW - FINGER

KW - health economic simulation

KW - prevention

U2 - 10.1002/alz.12698

DO - 10.1002/alz.12698

M3 - Article

AN - SCOPUS:85134245691

SN - 1552-5260

VL - 19

SP - 999

EP - 1008

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

IS - 3

ER -

Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program

Abstract

Funding

UN SDGs

Keywords

Publication forum classification

ASJC Scopus subject areas

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