Applied health economics : economic evaluation of lifestyle interventions to promote cognition in older adults with chronic stroke
department or school: Management, Faculty of (Okanagan)
data provider: DSpace
degree campus: UBCO
creator: Adjetey, Cassandra
issued: 2023-06-29T18:40:24Z
issued: 2023
related degree: Master of Arts - MA
degree grantor: University of British Columbia
description: Background: Cognitive impairment is a common and costly consequence of a stroke, occurring in about 30% of stroke survivors. Evidence suggests exercise and cognitive training can improve cognitive function among individuals with chronic stroke. What remains unknown, is whether exercise and/or cognitive training are cost-effective compared with usual care. Purpose: This study aims to examine the cost-effectiveness of exercise and cognitive training compared with a stretching and tone program from a healthcare system perspective of a 6-month intervention with a six-month follow-up. Method: An economic evaluation alongside a 6-month randomized controlled trial involving 120 community-dwelling adults with chronic stroke (i.e., at least 12 months post-stroke) in Metro Vancouver, Canada. Participants were aged 55 years and older, did not have dementia and were able to walk six meters. Participants were randomly assigned to i) EX, a multi-component exercise of strength, aerobic, and balance training (n=34), ii) ENRICH, cognitive and social enrichment activities (n=34), or iii) BAT, a stretching and toning program (control) (n=52). The economic evaluation assessed cost-effectiveness and cost-utility as the incremental cost per change in the Alzheimer’s Disease Assessment Scale – Cognitive-Plus (ADAS-Cog-Plus) and incremental cost per Quality Adjusted life year (QALY) using the Euro-Qol 5D three-level of the interventions respectively. Costs are reported in 2022 Canadian Dollars. Results: The mean age for all participants was 71 years (SD= 9) with about 46% female participants. At the end of the 6-month intervention, the incremental cost per change in ADAS-Cog-Plus showed that both EX and ENRICH were more effective and more costly compared with the BAT control group. The incremental benefits in ADAS-Cog were not sustained at 12 months. The incremental cost per change in QALY at 6 and 12 months showed that while EX was less costly and ENRICH more costly compared to the BAT gr…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/85178
note: APPLIED HEALTH ECONOMICS: ECONOMIC EVALUATION OF LIFESTYLE INTERVENTIONS TO PROMOTE COGNITION IN OLDER ADULTS WITH CHRONIC STROKE by Cassandra Adjetey Bachelor of Arts, University of British Columbia, Vancouver, 2019 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE COLLEGE OF GRADUATE STUDIES (Interdisciplinary Studies) (Community Engagement, Social Change, and Equity) THE UNIVERSITY OF BRITISH COLUMBIA (Okanagan) June 2023 © Cassandra Adjetey, 2023 ii The following individuals certify that they have read, and recommend to the College of Graduate Studies for acceptance, the thesis entitled: Applied health economics: economic evaluation of lifestyle intervention to promote cognition in older adults with chronic stroke submitted by Cassandra Adjetey in partial fulfillment of the requirements for the degree of Master of Arts in Interdisciplinary Studies – Community Engagement, Social Change, and Equity Examining Committee: Dr. Jennifer Davis (Faculty of Management, University of British Columbia – Okanagan) Supervisor Dr. Teresa Liu-Ambrose (Faculty of Medicine, Department of Physical Therapy, University of British Columbia – Vancouver) Co-supervisor Dr. Min Hu (Irving K. Barber Faculty of Arts and Social Science, Department of Economics, Philosophy and Political Science, University of British Columbia - Okanagan) Supervisory Committee Member Dr. Brodie Sakakibara (Faculty of Medicine, Occupational Science & Occupational Therapy, University of British Columbia – Vancouver) Supervisory Committee Member Dr. Nelly Oelke (Faculty of Health and Social Development, School of Nursing, University of British Columbia – Okanagan) External Examiner iii Abstract Background: Cognitive impairment is a common and costly consequence of a stroke, occurring in about 30% of stroke survivors. Evidence suggests exercise and cognitive training can improve cognitive function among individuals with chronic stroke. What remains unknown, is w…
has type: Thesis/Dissertation
date issued: 2023-09
is shown at: 10.14288/1.0433821
language: eng
degree discipline: Interdisciplinary Studies
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NonCommercial-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nc-nd/4.0/
scholar level: Graduate
contributor: Davis, Jennifer Colleen
contributor: Liu-Ambrose, Teresa
type: Text
identifier URI: http://hdl.handle.net/2429/85178