Ageing and dementia

Program Lead

To meet the demands created by a growing ageing population, our team undertakes a broad program of economics research with the aim to improve the quality of life and care for older adults and their informal carers.

We work closely with our collaborators in delivering high-quality evidence to inform health and aged care system change. Our research spans economic evaluation, outcome measurement research, and health services research, including the application of stated preferences methods to value non-market goods and services, such as informal care. In establishing evidence around the economic credentials of interventions in older adults, we apply most up-to-date research practices and standards.

Our specialist work includes the following:

  • Economic evaluation – trial based and model-based evaluations, cost analysis and return on investment studies
  • Outcome measurement research – including the psychometric assessment of existing outcome measures to inform the choice of measure(s)
  • Health services research – evaluating the healthcare use, costs and the disease burden (for example, quality of life losses) in older adults
  • Valuation of non-market goods or services – using stated-preferences research methods, we also conduct research in determining the value of non-market goods and services (includes undertaking discrete-choice experiments)

Recent highlights

Economic evaluation

Engel L, Le LK-D, Lee YY, Lal A, Mihalopoulos C. Reducing loneliness to prevent depression in older adults in Australia: a modelled cost-effectiveness analysis. Mental Health & Prevention. 2021 Dec;24:200212. doi: 10.1016/j.mhp.2021.200212.

This study evaluated the cost-effectiveness of the Friendship Enrichment Programme and a volunteer-led internet and computer training intervention showing that both interventions were cost saving with positive returns on investment. This study was part of a larger project funded by the National Mental Health Commission examining the cost-effectiveness of mental health prevention and promotion interventions.

Outcome measurement research

Engel L, Rand S, Hoefman R, Bucholc J, Mihalopoulos C, Muldowney A, Ugalde A, McCaffrey N. Measuring Carer Outcomes in an Economic Evaluation: A Content Comparison of the Adult Social Care Outcomes Toolkit for Carers, Carer Experience Scale, and Care-Related Quality of Life Using Exploratory Factor Analysis. Medical Decision Making. 2020 Oct;40(7):885-896. doi: 10.1177/0272989X20944193.

This study examined the content of the ASCOT-Carer, CES, and CarerQol using exploratory factor analysis, showing that although some overlap was observed, the three carer-related preference-based measures seem to tap into different constructs of carer-related quality of life and caring experiences and cannot be used interchangeably. This will guide further the selection of carer-related preference-based measures for use in economic evaluation.

Engel L, Bucholc J, Mihalopoulos C, Mulhern B, Ratcliffe J, Yates M, Hanna L. A qualitative exploration of the content and face validity of preference-based measures within the context of dementia. Health & Quality of Life Outcomes. 2020 Jun 11;18(1):178. doi: 10.1186/s12955-020-01425-w.

Improving the quality of life of people living with dementia is a key priority area but the measurement of quality of life in this population group remains a challenge. This study examined the content of six quality of life instruments, showing important shortcomings with regard to their ability to capture domains of quality of life important to people with dementia and their carers.

Health services research

Engel L, Hwang K, Panayiotou A, Watts JJ, Mihalopoulos C, Temple J, Batchelor F. Identifying patterns of potentially preventable hospitalisations in people living with dementia. BMC Health Services Research. 2022 Jun 20;22(1):794. doi: 10.1186/s12913-022-08195-9.

This study examined patterns of potentially preventable hospitalisations in people living with dementia, showing that 48% of hospitalisations between 2015-2016 were for conditions that could have been effectively managed and treated in the community, such as urinary tract infection or diabetes complications, particularly for those from culturally and linguistically diverse backgrounds.

Valuation of non-market goods or services

Engel L, Ajdukovic M, Bucholc J, McCaffrey N. Valuation of Informal Care Provided to People Living With Dementia: A Systematic Literature Review. Value in Health. 2021 Dec;24(12):1863-1870. doi: 10.1016/j.jval.2021.04.1283.

This review explored which valuation methods have been used to value informal care time provided to people with dementia. The review identified the replacement cost method as the most commonly used method, followed by the opportunity cost approach and the stated preference method based on willingness to pay. The associated hourly unit costs were estimated by the valuation method, which can be used in future economic evaluation and cost-of-illness studies.