{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T12:51:02Z","timestamp":1792587062286,"version":"4.5.0"},"reference-count":33,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T00:00:00Z","timestamp":1600473600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"national institute for health research","doi-asserted-by":"publisher","award":["PD-SPH-2015-10022"],"award-info":[{"award-number":["PD-SPH-2015-10022"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Med Decis Making"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Economic evaluations of lifestyle interventions, which aim to prevent diabetes\/cardiovascular disease (CVD), have not included dementia. Lifestyle interventions decrease dementia risk and extend life expectancy, leading to competing effects on health care costs. We aim to demonstrate the feasibility of including dementia in a public health cost-effectiveness analysis and quantify the overall impacts accounting for these competing effects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The School for Public Health Research (SPHR) diabetes prevention model describes individuals\u2019 risk of type 2 diabetes, microvascular outcomes, CVD, congestive heart failure, cancer, osteoarthritis, depression, and mortality in England. In version 3.1, we adapted the model to include dementia using published data from primary care databases, health surveys, and trials of dementia to describe dementia incidence, diagnosis, and disease progression. We estimate the impact of dementia on lifetime costs and quality-adjusted life years (QALYs) gained of the National Health Service diabetes prevention program (NHS DPP) from an NHS\/personal social services perspective with 3 scenarios: 1) no dementia, 2) dementia only, and 3) reduced dementia risk. Subgroup, parameter, and probabilistic sensitivity analyses were conducted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The lifetime cost savings of the NHS DPP per patient were \u00a3145 in the no-dementia scenario, \u00a3121 in the dementia-only scenario, and \u00a3167 in the reduced dementia risk scenario. The QALY gains increased by 0.0006 in dementia only and 0.0134 in reduced dementia risk. Dementia did not alter the recommendation that the NHS\/DPP is cost-effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Including dementia into a model of lifestyle interventions was feasible but did not change policy recommendations or modify health economic outcomes. The impact on health economic outcomes was largest where a direct impact on dementia incidence was assumed, particularly in elderly populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0272989x20946758","type":"journal-article","created":{"date-parts":[[2020,9,19]],"date-time":"2020-09-19T03:54:06Z","timestamp":1600487646000},"page":"912-923","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":19,"title":["The Impact of Including Costs and Outcomes of Dementia in a Health Economic Model to Evaluate Lifestyle Interventions to Prevent Diabetes and Cardiovascular Disease"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4189-8676","authenticated-orcid":false,"given":"Penny","family":"Breeze","sequence":"first","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Thomas","sequence":"additional","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Thokala","sequence":"additional","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Lafortune","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health, University of Cambridge, Cambridge, Cambridgeshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol","family":"Brayne","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health, University of Cambridge, Cambridge, Cambridgeshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Brennan","sequence":"additional","affiliation":[{"name":"School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,9,19]]},"reference":[{"key":"bibr1-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2017.1658"},{"key":"bibr2-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-016-0549-y"},{"key":"bibr3-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0144405"},{"key":"bibr4-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(06)70537-3"},{"key":"bibr5-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2007.04.381"},{"key":"bibr6-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(17)30040-6"},{"key":"bibr7-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30950-3"},{"key":"bibr8-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.2337\/dc13-2195"},{"key":"bibr9-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105033441801"},{"key":"bibr10-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012512"},{"key":"bibr11-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-014953"},{"key":"bibr12-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-014-0091-z"},{"key":"bibr13-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13314"},{"key":"bibr14-0272989X20946758","doi-asserted-by":"publisher","DOI":"10.1111\/dme.13349"},{"issue":"4","key":"bibr15-0272989X20946758","volume":"38","author":"Breeze P","year":"2015","journal-title":"J Public Health (Oxf)"},{"key":"bibr16-0272989X20946758","unstructured":"Banks J, Batty GD, Coughlin K, et al. 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