Utility Values for Dementia in Finland and Spain
Author(s)
Ursula Rochau, Assoc.-Prof. Priv.-Doz. Mag. Dr.1, veronika papon, MSc1, Marjan Arvandi, PhD1, Beate Jahn, PhD1, Kaisu H. Pitkälä, MD, PhD, professor emerita2, Laura Coll-Planas, PhD3, Montse Masó Aguado, PhD4, Jill S. Litt, PhD5, Uwe Siebert, MPH, MSc, ScD, MD6, Sibylle Puntscher, PhD1.
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2University of Helsinki, Department of General Practice and Helsinki University Hospital, Unit of Primary Care, University of Helsinki, Helsinki, Finland, 3Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 4Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 5Institute for Global Health (ISGlobal); CIBER Epidemiología y Salud Pública (CIBERESP); Universitat Pompeu Fabra (UPF), Barcelona, Spain, 6UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; Harvard Chan School of Public Health, Boston, MA, United States; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Hall in Tirol, Austria.
1Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health, Health Services Research and Health Technology Assessment, UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria, 2University of Helsinki, Department of General Practice and Helsinki University Hospital, Unit of Primary Care, University of Helsinki, Helsinki, Finland, 3Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 4Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Research Group On Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain, 5Institute for Global Health (ISGlobal); CIBER Epidemiología y Salud Pública (CIBERESP); Universitat Pompeu Fabra (UPF), Barcelona, Spain, 6UMIT TIROL - University for Health Sciences and Technology, Hall in Tirol, Austria; Harvard Chan School of Public Health, Boston, MA, United States; Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA, Hall in Tirol, Austria.
OBJECTIVES: Loneliness can have severe consequences on health and wellbeing. Loneliness is associated with an increased risk of cognitive decline and dementia. We sought utility values for dementia to inform evaluations of loneliness alleviating interventions in Finland and Spain using a decision-analytic model (DAM) within the EU-H2020 RECETAS project.
METHODS: We performed systematic literature searches in PubMed supplemented by manual searches to identify systematic reviews and meta-analyses reporting utility values for dementia elicited with the EQ-5D questionnaire. Studies were screened for eligibility and either a pooled or a single value was chosen. As utilities are often reported by dementia severity, a weighted utility based on the prevalence of dementia severity stages in Finland and Spain was estimated.
RESULTS: We identified 17 systematic reviews/meta-analyses for dementia. For Finland, we selected a single study. Caregiver-rated utility values summarized according to dementia stages are: 0.612 (mild dementia), 0.496 (moderate dementia), and 0.385 (severe dementia). No distribution of dementia severity stages for Finland was found. Therefore, the severity distribution, mild (50.4%), moderate (30.3%) and severe (19.3%) dementia, based on the Framingham Heart Study was used. The severity-weighted utility for dementia was 0.533. For Spain, two studies from the systematic search and one study from the manual search were pooled. Random-effects meta-analyses yielded utilities of 0.683 for mild, 0.539 for moderate, and 0.339 for severe dementia. Considering the distribution of dementia severity stages in Spain (26% mild, 54% moderate, 20% severe dementia) resulted in a mean utility of 0.537 for dementia in Spain.
CONCLUSIONS: Overall, we found satisfactory evidence on dementia-related utility values to populate our DAM for the Finnish and Spanish RECETAS analyses. The results from our decision analyses will allow us to guide lay persons, clinicians, and health-policy decision makers on the tradeoffs between benefits, harms and cost effectiveness of loneliness-alleviating interventions.
METHODS: We performed systematic literature searches in PubMed supplemented by manual searches to identify systematic reviews and meta-analyses reporting utility values for dementia elicited with the EQ-5D questionnaire. Studies were screened for eligibility and either a pooled or a single value was chosen. As utilities are often reported by dementia severity, a weighted utility based on the prevalence of dementia severity stages in Finland and Spain was estimated.
RESULTS: We identified 17 systematic reviews/meta-analyses for dementia. For Finland, we selected a single study. Caregiver-rated utility values summarized according to dementia stages are: 0.612 (mild dementia), 0.496 (moderate dementia), and 0.385 (severe dementia). No distribution of dementia severity stages for Finland was found. Therefore, the severity distribution, mild (50.4%), moderate (30.3%) and severe (19.3%) dementia, based on the Framingham Heart Study was used. The severity-weighted utility for dementia was 0.533. For Spain, two studies from the systematic search and one study from the manual search were pooled. Random-effects meta-analyses yielded utilities of 0.683 for mild, 0.539 for moderate, and 0.339 for severe dementia. Considering the distribution of dementia severity stages in Spain (26% mild, 54% moderate, 20% severe dementia) resulted in a mean utility of 0.537 for dementia in Spain.
CONCLUSIONS: Overall, we found satisfactory evidence on dementia-related utility values to populate our DAM for the Finnish and Spanish RECETAS analyses. The results from our decision analyses will allow us to guide lay persons, clinicians, and health-policy decision makers on the tradeoffs between benefits, harms and cost effectiveness of loneliness-alleviating interventions.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH276
Topic
Economic Evaluation, Epidemiology & Public Health, Methodological & Statistical Research
Topic Subcategory
Public Health
Disease
Mental Health (including addition)