Evidence map›Paper›PMID 40190002›Full record

Trial reportThe journal of prevention of Alzheimer's disease2025

The cost-effectiveness of an online intervention to prevent dementia: Results from the Maintain Your Brain (MYB) randomised controlled trial.

Heidi J Welberry, Li-Jung Elizabeth Ku, Sophy Tf Shih, Louisa R Jorm, Maria Fiatarone Singh, Michael Valenzuela, Jeewani Anupama Ginige, Kaarin J Anstey, Perminder S Sachdev, John J McNeil and 4 more

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The journal of prevention of Alzheimer's disease, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Heidi J WelberryCentre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
Li-Jung Elizabeth KuCentre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia; Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia. Electronic address: eljku@mail.ncku.edu.tw.
Sophy Tf ShihThe Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Louisa R JormCentre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
Maria Fiatarone SinghDiscipline of Exercise and Sport Science, School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Australia; Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Australia and Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Roslindale, MA, USA.
Michael ValenzuelaCentre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Jeewani Anupama GinigeSchool of Computer, Data and Mathematical Sciences, Western Sydney University, Penrith, New South Wales, Australia.
Kaarin J AnsteyUNSW Ageing Futures Institute, University of New South Wales, Sydney, New South Wales, Australia; School of Psychology, University of New South Wales, New South Wales, Australia; Brain Health and Dementia Centre, Neuroscience Research Australia, New South Wales, Australia.
Perminder S SachdevCentre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, New South Wales, Australia.
John J McNeilSchool of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Nicola T LautenschlagerDepartment of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia; Royal Melbourne Hospital Mental Health Services, Royal Melbourne Hospital, Parkville, Victoria, Australia.
Megan HeffernanThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.
Tiffany ChauCentre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.
Henry BrodatyCentre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Maintain Your Brain (MYB) randomised controlled trial (RCT) examined the effect of a multi-domain internet-based dementia prevention program against a control group (information only).

objectivesA cost-effective analysis (CEA) quantified the differences in costs (direct healthcare and program costs) and effectiveness outcomes between the intervention and control groups from a healthcare sector perspective.

designAn economic evaluation was conducted alongside the MYB RCT over three years.

settingAustralians aged 55-77 years with at least 2 identified remediable risk factors for cognitive decline/dementia recruited from communities in New South Wales.

participantsThere were 3,025 participants in the intervention group and 3,033 in the control group with available linked healthcare data via the Sax Institute's 45 and Up Study out of the 6104 enrolled in the trial (99.2% of total cohort).

interventionThe MYB trial comprised a personalised schedule of online coaching in physical activity, nutrition, cognitive activity, and depression or anxiety management. MEASUREMENTS: The two effectiveness outcomes were global cognition composite (GCC) scores and the Australian National University-Alzheimer's Disease Risk Index -short form (ANU-ADRI-SF) questionnaire scores. Costs included MYB program costs and the direct healthcare costs incurred by the MYB participants. All costs were reported in Australian dollars (AUD$) during the trial period. The time horizon of this analysis was 3 years after randomisation (2018-2021). Incremental cost-effectiveness ratio (ICERs) between the intervention and the control groups were calculated by comparing the average difference in costs to a mean difference in z score for GCC and ANU-ADRI-SF score using the bootstrapped means and 95% Confidence Intervals.

resultsThe total unadjusted program and healthcare costs over three years were similar between groups (AUD$16,521 per person in the control group and AUD$16,473 in the intervention group). After adjusting for baseline characteristics, the average difference between groups in total cost per person at three years was not statistically different: AUD$467 favouring the control group (95%CI: -$552 - $1585). This was compared to a significant mean difference (improvement) in GCC z score at three years of 0.18 (95%CI: 0.13, 0.23) and -0.57 (95%CI: -0.95, -0.24) point difference in ANU-ADRI-SF for the intervention versus control. The base case ICERs were AUD$2,568 per 1 standard deviation in z score and $823 per reduction of 1 ANU-ADRI-SF point. With 1000 bootstrapped replications, the scatterplots of ICER ellipses suggest that the MYB intervention was more effective than the control group and with no significant difference in overall healthcare costs.

conclusionThe MYB trial showed cost-effectiveness for preventing cognitive decline and reducing dementia risk. Longer-term follow-up and dissemination to other cohorts is needed to confirm the impact on preventing future cases of dementia and relevance to other socio-economic and cultural/ethnic groups than those enrolled in the original trial.

Indexed as

Cost-Benefit AnalysisDementiaInternet-Based InterventionAgedAustraliaCognitive DysfunctionFemaleHealth Care CostsHumansInternetMaleMiddle AgedNew South WalesCost-effectivenessDementiaHealth Care CostsPreventionRandomised controlled trial

Identifiers

PMID40190002
PMCPMC12434251

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.