Economic evaluation of population-level dementia prevention strategies in China: informing policy and public health action.

INTRODUCTION

While it has been postulated that population-based strategies targeting modifiable dementia risk factors are cost effective in high-income settings, their health and economic impact in China remains unclear.

METHODS

A Markov model evaluated five interventions: salt substitution, smoke-free legislation, increased tobacco tax, sugar-sweetened beverage tax, and alcohol tax. Outcomes included dementia cases, deaths averted, life years gained, and lifetime cost-savings, assessed from a societal perspective over an infinite time horizon. Subgroup and sensitivity analyses were performed.

RESULTS

All interventions were assessed to be cost-saving. Salt substitution was modeled to have the greatest impact, resulting in 1,940,000 quality-adjusted life years gained and lifetime cost savings of US$65 to US$70 billion. Smoke-free policies and tobacco taxes also showed significant benefits. Beverage and alcohol taxes had smaller but meaningful effects. Males generally benefited more.

DISCUSSION: We estimated that population-level interventions would reduce costs in China, with the largest gains from targeting hypertension and smoking. Prioritizing such strategies may generate substantial health gains while reducing long-term societal costs.