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An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI.

METHODS

Economic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months.

RESULTS

Based on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04).

CONCLUSIONS

Resistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.

TRIAL REGISTRATION

ClinicalTrials.gov NCT00958867.

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  • Authors+Show Affiliations

    ,

    Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada.

    , , , , , ,

    Source

    PloS one 8:5 2013 pg e63031

    MeSH

    Aged
    Aged, 80 and over
    Cognitive Dysfunction
    Cost-Benefit Analysis
    Exercise
    Female
    Health Care Costs
    Humans
    Patient Compliance
    Postural Balance
    Residence Characteristics
    Resistance Training
    Treatment Outcome

    Pub Type(s)

    Comparative Study
    Journal Article
    Randomized Controlled Trial
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23690976

    Citation

    Davis, Jennifer C., et al. "An Economic Evaluation of Resistance Training and Aerobic Training Versus Balance and Toning Exercises in Older Adults With Mild Cognitive Impairment." PloS One, vol. 8, no. 5, 2013, pp. e63031.
    Davis JC, Bryan S, Marra CA, et al. An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. PLoS ONE. 2013;8(5):e63031.
    Davis, J. C., Bryan, S., Marra, C. A., Sharma, D., Chan, A., Beattie, B. L., ... Liu-Ambrose, T. (2013). An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. PloS One, 8(5), pp. e63031. doi:10.1371/journal.pone.0063031.
    Davis JC, et al. An Economic Evaluation of Resistance Training and Aerobic Training Versus Balance and Toning Exercises in Older Adults With Mild Cognitive Impairment. PLoS ONE. 2013;8(5):e63031. PubMed PMID: 23690976.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment. AU - Davis,Jennifer C, AU - Bryan,Stirling, AU - Marra,Carlo A, AU - Sharma,Devika, AU - Chan,Alison, AU - Beattie,B Lynn, AU - Graf,Peter, AU - Liu-Ambrose,Teresa, Y1 - 2013/05/14/ PY - 2013/01/25/received PY - 2013/03/27/accepted PY - 2013/5/22/entrez PY - 2013/5/22/pubmed PY - 2014/1/1/medline SP - e63031 EP - e63031 JF - PloS one JO - PLoS ONE VL - 8 IS - 5 N2 - BACKGROUND: Mild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI. METHODS: Economic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months. RESULTS: Based on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04). CONCLUSIONS: Resistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI. TRIAL REGISTRATION: ClinicalTrials.gov NCT00958867. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/23690976/An_economic_evaluation_of_resistance_training_and_aerobic_training_versus_balance_and_toning_exercises_in_older_adults_with_mild_cognitive_impairment_ L2 - http://dx.plos.org/10.1371/journal.pone.0063031 DB - PRIME DP - Unbound Medicine ER -