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J Gerontol A Biol Sci Med Sci. 2016 May;71(5):656-62. doi: 10.1093/gerona/glw001. Epub 2016 Feb 17.

Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability.

Author information

1
Department of Family Medicine and Public Health, University of California San Diego, La Jolla. VA San Diego Healthcare System, California. egroessl@ucsd.edu.
2
Agency for Healthcare Research and Quality, Rockville, Maryland.
3
Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, California.
4
Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge.
5
Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
6
Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.
7
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
8
Department of Health Research & Policy and Medicine, Stanford University School of Medicine, California.
9
Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina.
10
Department of Aging and Geriatric Research, University of Florida, Gainesville.
11
Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
12
Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.

Abstract

BACKGROUND:

Losing the ability to walk safely and independently is a major concern for many older adults. The Lifestyle Interventions and Independence for Elders study recently demonstrated that a physical activity (PA) intervention can delay the onset of major mobility disability. Our objective is to examine the resources required to deliver the PA intervention and calculate the incremental cost-effectiveness compared with a health education intervention.

METHODS:

The Lifestyle Interventions and Independence for Elders study enrolled 1,635 older adults at risk for mobility disability. They were recruited at eight field centers and randomly assigned to either PA or health education. The PA program consisted of 50-minute center-based exercise 2× weekly, augmented with home-based activity to achieve a goal of 150 min/wk of PA. Health education consisted of weekly workshops for 26 weeks, and monthly sessions thereafter. Analyses were conducted from a health system perspective, with a 2.6-year time horizon.

RESULTS:

The average cost per participant over 2.6 years was US$3,302 and US$1,001 for the PA and health education interventions, respectively. PA participants accrued 0.047 per person more Quality-Adjusted Life-Years (QALYs) than health education participants. PA interventions costs were slightly higher than other recent PA interventions. The incremental cost-effectiveness ratios were US$42,376/major mobility disability prevented and US$49,167/QALY. Sensitivity analyses indicated that results were relatively robust to varied assumptions.

CONCLUSIONS:

The PA intervention costs and QALYs gained are comparable to those found in other studies. The ICERS are less than many commonly recommended medical treatments. Implementing the intervention in non-research settings may reduce costs further.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT01072500.

KEYWORDS:

Cost-effectiveness; Older adults; Physical activity

PMID:
26888433
PMCID:
PMC5007742
DOI:
10.1093/gerona/glw001
[Indexed for MEDLINE]
Free PMC Article

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