Cost-effectiveness of a multicomponent training programme for older adults with decreased functional capacity: An economic evaluation

Subías-Perié, J. (Universidad de Zaragoza) ; Navarrete-Villanueva, D. (Universidad de Zaragoza) ; Fernández-García, A.I. (Universidad de Zaragoza) ; Moradell, A. (Universidad de Zaragoza) ; Alcalá-Nalvaiz, J.T. (Universidad de Zaragoza) ; Groessl, E.J. ; Ara, I. ; Vila-Maldonado, S. ; Pérez-Gómez, J. ; Gonzalez-Gross, M. ; Gómez-Cabello, A. ; Vicente-Rodríguez, G. (Universidad de Zaragoza) ; Casajús, J.A. (Universidad de Zaragoza)

Resumen: Purpose: This study aimed to (I) examine the resources required to implement a multicomponent training (MCT) programme, (II) assess its impact on health care utilisation cost, and (III) evaluate its cost-effectiveness in older adults with decreased functional capacity.
Methods: A total of 123 older adults (mean age: 80.3 ± 5.9 years) were allocated into a control (CON, n = 64) or training group (TRAIN, n = 59). The TRAIN group performed a 6-month MCT programme, which included aerobic exercise, resistance training, flexibility and balance components, while the CON group continued with their usual care. Functional capacity, frailty and health-related quality of life (HRQoL) were assessed at three different timepoints using the Short Physical Performance Battery (SPPB), Frailty Phenotype of Fried and the EuroQol-5D (EQ-5D), respectively. Primary outcome measures included the costs of delivering the MCT, health care utilisation, quality-adjusted life-years (QALYs), and the incremental cost effectiveness ratio (ICER). Analyses were conducted from a health system perspective with a 6-month time horizon.
Results: While no significant changes were observed in the CON group, the TRAIN group showed improvements in SPPB (+3.38 ± 1.32), HRQoL (+0.07 ± 0.12), and frailty (−0.64 ± 1.06) (all p < 0.05). The average cost per TRAIN participant was €164. Health care utilisation cost was lower for TRAIN compared to CON (€3091 and €4135, respectively). The ICERs were €115/point increase in SPPB and €407/point reduction in frailty score. The cost per QALY gained by the TRAIN participant relative to the usual care cost was €6274. At a willingness-to-pay threshold of €49,000/QALY (Spanish Health System), the probability of the exercise intervention being cost-effective was 100 %.
Conclusions: The 6-month Exernet-Elder 3.0 training programme demonstrated an ICER of €115 per SPPB point gained, €407 per point of frailty reduction, and €6274 per QALY gained. The intervention was low-cost (€164 per participant) and produced clinically meaningful improvements in functional capacity, HRQoL, and frailty. These findings underscore the importance of integrating a structured, group-based exercise programmes into public health strategies to address the growing socioeconomic and health burden associated with ageing populations.

Idioma: Inglés

DOI: 10.1016/j.exger.2025.112911

Año: 2025

Publicado en: Experimental gerontology 211 (2025), 112911 [15 pp.]
ISSN: 0531-5565

Financiación: info:eu-repo/grantAgreement/ES/DGA-IIU/1-2020
Financiación: info:eu-repo/grantAgreement/ES/MCIU/FPU18-05787
Financiación: info:eu-repo/grantAgreement/ES/MINECO/BES-2017-081402

Tipo y forma: Article (Published version)

Área (Departamento): Área Estadís. Investig. Opera. (Dpto. Métodos Estadísticos)
Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)
Área (Departamento): Área Nutrición Bromatología (Dpto. Produc.Animal Cienc.Ali.)
Área (Departamento): Área Educación Física y Depor. (Dpto. Fisiatría y Enfermería)