Table 3 Summary of cost-effectiveness findings of the reviewed studies

Baal et al. [29] (2016)

No MCI or dementia

Increase of physical activity level by 1 level (out of total 5 levels) vs. no increase

Life years:+  

If prevention is targeted at the physically inactive by increasing physical activity level, savings in dementia-related costs outweigh the additional spending in life years gained

Wimo et al. [30] (2022)

No MCI or dementia

2-year multidomain program (nutritional counseling, multicomponent exercise, and cognitive training) vs. standard-of-care

QALY: + 

The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia

Kato et al. [22] (2022)

No MCI or dementia

90-min weekly combined physical and cognitive session

QALY: + 

A program targeting community-dwelling healthy adults aged 65 years old could be cost-effective

Davis et al. [26] (2013)

MCI

6-month resistance training or aerobic training vs. balance/tone classes (control)

Executive cognitive function:+  

Resistance training and aerobic training result in healthcare cost saving and are more effective than balance/tone classes in older adults with MCI. Resistance training is a promising strategy to alter the trajectory of cognitive decline in seniors with MCI

Davis et al. [27] (2017)

MCI

6-month aerobic training + standard-of-care + education vs. standard-of-care + education

QALY:+  

Aerobic training represents an attractive and potentially cost-effective strategy for older adults with mild subcortical vascular cognitive impairment

Eckert et al. [28] (2021)

MCI

12-week home-based exercise (walking, balance, strength training) vs. flexibility training

Physical performance and QALY:+  

The home-based exercise intervention demonstrated high probability of cost-effectiveness in terms of improved physical performance in older adults with MCI following discharge from ward rehabilitation. The intervention had high probability of being cost-effective in terms of QALY when using a high willingness to pay threshold

Khan et al. [31] (2019)

Dementia

12-month aerobic and resistance exercise classes vs. standard-of-care

Cognitive outcomes and QALY:–  

Exercise is not cost-effective in slowing cognitive impairment in people with mild to moderate dementia

Pitkälä et al. [24] (2013)

Dementia

12-month group-based exercise or home-based exercise vs. standard-of-care

Physical functioning and mobility:

+ (home-based exercise)

- (group-based exercise)

An intensive and long-term exercise program administrated at patient’s home had beneficial effects on the physical functioning of patients with Alzheimer's disease without increasing the total costs of health and social services or causing any significant adverse effects

Sopina et al. [32] (2017)

Dementia

16-week aerobic exercises (on bicycle, cross trainer, and treadmill) vs. usual treatment

QALY:–  

The exercise intervention is unlikely to be cost-effective within the commonly applied threshold values

Van Santen et al. [23] (2021)

Dementia

6-month exergaming (interacting cycling) + regular activity program (music listening, singing, arts and crafts, cooking, gymnastics, and outdoor walking) vs. regular activity program

QALY, physical activity function and mobility:–  

Exergaming by participants with dementia in daycare center was nor cost-effective compared to care as usual for our primary outcome measures: QALYs, physical activity and mobility

D’Amico et al. [25] (2016)

Dementia

12-week daily walking program vs. standard-of-care

BPSD: +  

QALY:– 

For individuals with dementia, exercise could potentially be a cost-effective intervention for outcomes measured by BPSD, but not when measured by QALYs