On 9 July, an international team of researchers published an article reviewing health economic models of dementia diagnosis in the Alzheimer's & Dementia: Behavior & Socioeconomics of Aging journal. The review found that most models supported the cost-effectiveness of current diagnostic strategies, such as the use of cerebrospinal fluid (CSF) biomarkers to confirm Alzheimer’s disease, with reported incremental cost-effectiveness ratios below standard willingness-to-pay thresholds. Researchers systematically analysed 32 studies published between 2000 and 2024 that used decision modelling to evaluate diagnostic or assessment strategies across all dementia stages. These included fluid, imaging and genetic biomarkers, as well as early assessment methods before specialist referral.
The studies were critically appraised using the Philips checklist and a narrative synthesis. The models varied in approach and quality, with several methodological limitations identified. Most failed to account for capacity constraints or broader benefits and harms of diagnosis, and few considered test interdependencies or validated their findings externally. The authors conclude that while current models support clinical guideline implementation, future studies should improve methodological robustness to support more credible decision-making. The article has been published open access and can be read here: https://doi.org/10.1002/bsa3.70027
