The ACTIVE cognitive training trial and predicted medical expenditures

Fredric D. Wolinsky, Henry W. Mahncke, Mark Kosinski, Frederick Unverzagt, David M. Smith, Richard N. Jones, Anne Stoddard, Sharon L. Tennstedt

Research output: Contribution to journalArticle

31 Citations (Scopus)

Abstract

Background. Health care expenditures for older adults are disproportionately high and increasing at both the individual and population levels. We evaluated the effects of the three cognitive training interventions (memory, reasoning, or speed of processing) in the ACTIVE study on changes in predicted medical care expenditures. Methods. ACTIVE was a multisite randomized controlled trial of older adults ( 65). Five-year follow-up data were available for 1,804 of the 2,802 participants. Propensity score weighting was used to adjust for potential attrition bias. Changes in predicted annualmedical expenditures were calculated at the first and fifth annual follow-up assessments using a new method for translating functional status scores. Multiple linear regression methods were used in this cost-offset analysis. Results. At one and five years post-training, annual predicted expenditures declinedby $223 (p =.024) and $128 (p =.309), respectively, in the speed of processing treatment group, but there were no statistically significant changes in the memory or reasoning treatment groups compared to the no-contact control group at either period. Statistical adjustment for age, race, education, MMSE scores, ADL and IADL performance scores, EPT scores, chronic condition counts, and the SF-36 PCS and MCS scores at baseline did not alter the one-year ($244; p =.012) or five-year ($143; p =.250) expenditure declines in the speed of processing treatment group. Conclusion. The speed of processing intervention significantly reduced subsequent annual predicted medical care expenditures at the one-year post-baseline comparison, but annual savings were no longer statistically significant at the five-year post-baseline comparison.

Original languageEnglish
Article number109
JournalBMC Health Services Research
Volume9
DOIs
StatePublished - 2009

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Health Expenditures
Propensity Score
Activities of Daily Living
Linear Models
Therapeutics
Randomized Controlled Trials
Learning
Delivery of Health Care
Education
Costs and Cost Analysis
Control Groups
Population

ASJC Scopus subject areas

  • Health Policy

Cite this

Wolinsky, F. D., Mahncke, H. W., Kosinski, M., Unverzagt, F., Smith, D. M., Jones, R. N., ... Tennstedt, S. L. (2009). The ACTIVE cognitive training trial and predicted medical expenditures. BMC Health Services Research, 9, [109]. https://doi.org/10.1186/1472-6963-9-109

The ACTIVE cognitive training trial and predicted medical expenditures. / Wolinsky, Fredric D.; Mahncke, Henry W.; Kosinski, Mark; Unverzagt, Frederick; Smith, David M.; Jones, Richard N.; Stoddard, Anne; Tennstedt, Sharon L.

In: BMC Health Services Research, Vol. 9, 109, 2009.

Research output: Contribution to journalArticle

Wolinsky, FD, Mahncke, HW, Kosinski, M, Unverzagt, F, Smith, DM, Jones, RN, Stoddard, A & Tennstedt, SL 2009, 'The ACTIVE cognitive training trial and predicted medical expenditures', BMC Health Services Research, vol. 9, 109. https://doi.org/10.1186/1472-6963-9-109
Wolinsky, Fredric D. ; Mahncke, Henry W. ; Kosinski, Mark ; Unverzagt, Frederick ; Smith, David M. ; Jones, Richard N. ; Stoddard, Anne ; Tennstedt, Sharon L. / The ACTIVE cognitive training trial and predicted medical expenditures. In: BMC Health Services Research. 2009 ; Vol. 9.
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