The evidence

Introduction

The evidence statements from 3 reviews are provided by Cambridge Institute of Public Health. The summary points are from review 4 that was done in‑house by NICE.

This section lists how the evidence statements and expert papers link to the recommendations and sets out a brief summary of findings from the economic analysis.

Expert papers

Expert papers 1–10. See evidence.

Economic modelling

The model was exploratory in nature and as such did not report a single estimate of cost‑effectiveness but presented a series of threshold analyses to see the conditions under which cost‑effectiveness can be achieved.

Overall, the model found that population‑level and individual-level interventions that aim to increase the physical activity of people in mid-life have the potential to be highly cost‑effective. Population‑level interventions were found to have a slightly greater potential of being cost‑effective at lower thresholds of willingness to pay than individual‑level interventions when aimed at the general population. However, individual‑level interventions were found to be cost‑effective at acceptable willingness to pay thresholds (below £20,000) when targeted at inactive people under certain assumptions.

The results for both types of intervention were varied extensively in a number of sensitivity and scenario analyses. The most crucial determinant for interventions to be cost‑effective is whether people succeed in maintaining increased levels of physical activity over their lives. The dose‑response relationship between physical activity in mid‑life and risk of developing dementia in later life also influences the cost‑effectiveness.

The specific scenarios considered and the full results can be found in the economic modelling report.