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

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26888433
10.1093/gerona/glw001
PMC5007742
The journals of gerontology. Series A, Biological sciences and medical sciences
May 1, 2016
Erik J Groessl5, Robert M Kaplan1, Cynthia M Castro Sweet11, Timothy Church10, Mark A Espeland3, Thomas M Gill7, Nancy W Glynn4, Abby C King6, Stephen Kritchevsky12, Todd Manini2, Mary M McDermott8, Kieran F Reid9, Julia Rushing3, Marco Pahor2, LIFE Study Group
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  • 1
    Agency for Healthcare Research and Quality, Rockville, Maryland.
  • 2
    Department of Aging and Geriatric Research, University of Florida, Gainesville.
  • 3
    Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
  • 4
    Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania.
  • 5
    Department of Family Medicine and Public Health, University of California San Diego, La Jolla. VA San Diego Healthcare System, California. egroessl@ucsd.edu.
  • 6
    Department of Health Research & Policy and Medicine, Stanford University School of Medicine, California.
  • 7
    Department of Internal Medicine, Yale School of Medicine, Yale University, New Haven, Connecticut.
  • 8
    Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
  • 9
    Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts.
  • 10
    Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge.
  • 11
    Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, California.
  • 12
    Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Exercise Therapy, Mobility Limitation, Health Education, Quality of Life, Walking, Male, Postural Balance, Life Style, United States, Cost-Benefit Analysis, Humans, Female, Aged, Aged, 80 and over
#UO1 AG22376, 1I01CX000927-01A1, UL1 TR001085, UL1 RR025744, 1R24HD065688-01A1, K07 AG043587, R24 HD065688, P30 AG021342, 3U01AG022376-05A2S, P30 AG031679, P30 AG021332, P30 AG024827, P30 AG028740, U01 AG022376
Groessl EJ, Kaplan RM, Castro Sweet CM, Church T, Espeland MA, Gill TM, Glynn NW, King AC, Kritchevsky S, Manini T, McDermott MM, Reid KF, Rushing J, Pahor M, LIFE Study Group. Cost-effectiveness of the LIFE Physical Activity Intervention for Older Adults at Increased Risk for Mobility Disability. The journals of gerontology. Series A, Biological sciences and medical sciences 2016 May.

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.