Economic evaluations of strategies targeting pre-diagnosis dementia populations: A systematic review.

This review aims to appraise and summarize the best available evidence from economic evaluations (EEs) of strategies targeting populations prior to a diagnosis of dementia. A comprehensive search was conducted in EMBASE, PubMed, EconLit, Web of Science, Cumulative Index to Nursing and Allied Health (CINAHL), and The NHS Economic Evaluation Database (NHS EED). Publications were dually screened and assessed against eligibility criteria, and reporting quality was appraised using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) framework. Seventeen full EEs met the inclusion criteria; all were conducted in high-income countries and covered strategies in identification (29%), risk reduction (65%), and other strategies (6%). The number of publications from 2016 to 2025 tripled compared to the preceding periods. Most risk-reduction strategies were cost-effective and exhibited high reporting quality. The average reporting quality, based on the CHEERS framework, was 72%, with a noticeable improvement observed in articles published after 2020. Overall, the findings suggest that most risk-reduction strategies may offer good value for money. However, evidence remains limited, specifically in low- and middle-income countries; therefore, additional EEs are needed to guide future investment in strategies targeting pre-diagnosis dementia populations.