OBJECTIVES

According to the WHO, Alzheimer Disease represents approximately 50 million of demented people with a societal cost estimated to US$ 818 billion worldwide. Nevertheless, no curative treatment is available putting forward the need to develop prevention strategies. Current evidences suggest that nutrition, physical exercise, cognitive activity and social stimulation may improve cognitive health. We aim to assess the efficiency of an isolated supplementation with omega-3 fatty acid (OMG3), an isolated multidomain intervention (IM) (nutritional counseling, physical exercise, cognitive stimulation) or both interventions together (OMG3+IM) on the change of cognitive functions in comparison with a placebo.

METHODS

We have used data from the Multidomain Alzheimer Preventive Trial (MAPT) study, which focus on change in memory function, through a composite score combining four cognitive tests, after 3 years of follow-up of frail subjects aged 70 years and older in France. Effectiveness used was the per-10 percent of no aggravation in memory function. Health insurance perspective was taken into account and direct costs were included in the analysis. Incremental Cost Effectiveness Ratio (ICER) and its 95% confident ellipse were implemented for each strategy in comparison with placebo.

RESULTS

Analyses were carried out on 1525 patients. Per 10 percent of no aggravation at 3 years were respectively 2.92, 2.47, 3.18 and 2.99 for placebo, OMG3, IM and OMG3+IM strategy. Mean costs per patients at 3 years were respectively €5,508; €6,404; €6,164; €7,299 for placebo, OMG3, IM and OMG3 + IM strategies. The OMG3 strategy was dominated while ICER for IM and OMG3+IM were estimated to €2,538 and €24,341 per 10% of no aggravation respectively compared to the placebo. Conclusions do not change according to deterministic and probabilistic sensitive analyses.

CONCLUSIONS

According to ICERs and confident ellipses the IM strategy were assessed as the most efficient intervention.