title: An economic evaluation of resistance training and aerobic training versus balance and toning exercises in older adults with mild cognitive impairment.
abstract: BACKGROUND
  Mild cognitive impairment (MCI) represents a critical window to intervene against dementia. Exercise training is a promising intervention strategy, but the efficiency (i.e., relationship of costs and consequences) of such types of training remains unknown. Thus, we estimated the incremental cost-effectiveness of resistance training or aerobic training compared with balance and tone exercises in terms of changes in executive cognitive function among senior women with probable MCI.
  
  
  METHODS
  Economic evaluation conducted concurrently with a six-month three arm randomized controlled trial including eighty-six community dwelling women aged 70 to 80 years living in Vancouver, Canada. Participants received twice-weekly resistance training (n = 28), twice weekly aerobic training (n = 30) or twice-weekly balance and tone (control group) classes (n = 28) for 6 months. The primary outcome measure of the Exercise for Cognition and Everyday Living (EXCEL) study assessed executive cognitive function, a test of selective attention and conflict resolution (i.e., Stroop Test). We collected healthcare resource utilization costs over six months.
  
  
  RESULTS
  Based on the bootstrapped estimates from our base case analysis, we found that both the aerobic training and resistance training interventions were less costly than twice weekly balance and tone classes. Compared with the balance and tone group, the resistance-training group had significantly improved performance on the Stroop Test (p = 0.04).
  
  
  CONCLUSIONS
  Resistance training and aerobic training result in health care cost saving and are more effective than balance and tone classes after only 6 months of intervention. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00958867.
authors.affiliation: Centre for Clinical Epidemiology and Evaluation, University of British Columbia, Vancouver, Canada.
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Davis
authors.forename: Stirling
authors.initials: S
authors.lastname: Bryan
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
authors.forename: Devika
authors.initials: D
authors.lastname: Sharma
authors.forename: Alison
authors.initials: A
authors.lastname: Chan
authors.forename: B Lynn
authors.initials: BL
authors.lastname: Beattie
authors.forename: Peter
authors.initials: P
authors.lastname: Graf
authors.forename: Teresa
authors.initials: T
authors.lastname: Liu-Ambrose
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000191:economics* / Q000503:physiopathology / Q000628:therapy*; D003362:Cost-Benefit Analysis; D015444:Exercise; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D006801:Humans; D010349:Patient Compliance / Q000706:statistics & numerical data; D004856:Postural Balance; D012111:Residence Characteristics / Q000706:statistics & numerical data; D055070:Resistance Training / Q000191:economics*; D016896:Treatment Outcome