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Accepted manuscript

The cost of a Mediterranean Diet and walking intervention to reduce risk of dementia and improve quality of life in independent living populations in Australia – The MedWalk RCT

Published online by Cambridge University Press:  17 October 2025

Ella L. Bracci*
Affiliation:
Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia
Courtney R. Davis
Affiliation:
Justice and Society, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia
Denny Meyer
Affiliation:
Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
Michael Kingsley
Affiliation:
Department of Exercise Sciences, The University of Auckland, Auckland, New Zealand. Holsworth Research Initiative, La Trobe University, Bendigo, Victoria, Australia.
Jeff Breckon
Affiliation:
School of Health and Life Sciences, Teesside University, Middlesbrough, United Kingdom
Anne-Marie Minihane
Affiliation:
Nutrition and Preventive Medicine, Norwich Medical School, University of East Anglia (UEA), NORWICH, NR4 7UQ, UK
Catherine Itsiopoulos
Affiliation:
School of Health and Biomedical Sciences, RMIT University, Victoria, Australia
Helen Macpherson
Affiliation:
Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, VIC, Australia
Andrew Scholey
Affiliation:
Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia Department of Psychology, Northumbria University, Newcastle upon Tyne, NE6 8ST UK
Kade Davison
Affiliation:
Allied Health and Human Performance; Alliance for Research in Exercise, Nutrition and Activity; University of South Australia
Kathryn A. Dyer
Affiliation:
Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia
Greg Kennedy
Affiliation:
Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
Andrew Pipingas
Affiliation:
Centre for Mental Health and Brain Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
Karen J. Murphy
Affiliation:
Clinical and Health Sciences, Alliance for Research in Exercise, Nutrition and Activity, University of South Australia, Australia
Leonie Segal
Affiliation:
Health Economics and Social Policy Group, Allied Health & Human Performance, University of South Australia, Adelaide, South Australia, Australia.
*
*Corresponding author: Ella L. Bracci; brael002@mymail.unisa.edu.au
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Abstract

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There is growing evidence that optimising dietary quality and engaging in physical activity (PA) can reduce dementia and cognitive decline risk and improve psychosocial health and quality of life (QoL). Multimodal interventions focusing on diet and PA are recognised as significant strategies to tackle these behavioural risk factors, however, the cost-effectiveness of such interventions is seldom reported. A limited cost consequence based on a 12-month cluster randomized Mediterranean Diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Program costs ($AUD2024) covered staff to deliver the MedWalk program and foods to support dietary behaviour change. The primary outcome measure of this study was change in QoL utility score, measured using the Assessment of Quality of Life (AQoL-8D). Change scores were compared for the groups using general linear models while controlling for demographic factors associated with baseline group differences and attrition. Change in QoL (decreased, maintained, or improved) was determined using a crosstabulation test. MedWalk program costs were estimated at $2,695 AUD per participant and control group cost at $165 per person – a differential cost of $2,530. Mean change in utility scores from baseline to 12-months were not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (20.3% MedWalk vs 42.6% control group) (p=.020). A MedDiet and walking intervention may have a role in preventing decline in QoL of older Australians, however, longer term follow up would be beneficial to see if this is maintained.

Information

Type
Research Article
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of The Nutrition Society