|GROESSL, ERIK - University Of California|
|KAPLAN, ROBERT - Agency For Healthcare Research And Quality (AHRQ)|
|CASTRO-SWEET, CYNTHIA - Stanford University|
|CHURCH, TIMOTHY - Pennington Biomedical Research Center|
|ESPELAND, MARK - Wake Forest University|
|GILL, THOMAS - Yale University|
|GLYNN, NANCY - University Of Pittsburgh|
|KING, ABBY - Stanford University|
|KRITCHEVSKY, STEPHEN - Wake Forest University|
|MANINI, TODD - University Of Florida|
|MCDERMOTT, MARY - Northwestern University|
|REID, KIERAN - Jean Mayer Human Nutrition Research Center On Aging At Tufts University|
|RUSHING, JULIA - Wake Forest University|
|PAHOR, MARCO - University Of Florida|
Submitted to: Journal of Gerontology Medical Science
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 12/28/2015
Publication Date: 2/17/2016
Citation: Groessl, E.J., Kaplan, R.M., Castro-Sweet, C.M., Church, T., Espeland, M., Gill, T., Glynn, N., King, A., Kritchevsky, S., Manini, T., Mcdermott, M.M., Reid, K.F., Rushing, J., Pahor, M. 2016. Cost effectiveness of the LIFE physical activity intervention for older adults at increased risk for mobility disability. Journal of Gerontology Medical Science. 71(5):656-662. doi: 10.1093/gerona/glw001.
Interpretive Summary: Losing the ability to walk is a major concern for many older adults. The Lifestyle Interventions and Independence for Elders (LIFE) study recently demonstrated that a physical activity intervention can delay the onset of major mobility disability in older persons. The current investigation examined the cost effectiveness of the LIFE physical activity intervention compared to a health education intervention in the LIFE study, which enrolled 1,635 mobility limited older adults and studied them for 2.6 years. The average cost per participant over 2.6 years was US$3,302 and US$1,001 for the physical activity and health education interventions, respectively. The physical activity participants accrued 0.047 per person more Quality Adjusted Life Years than health education participants. In conclusion, the LIFE physical activity intervention reduced mobility disability and increased health related quality of life over time. The overall costs of this physical activity intervention are comparable with similar beneficial physical activity interventions after adjusting for inflation, despite having older, more vulnerable study participants.
Technical 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 150min/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.