Systematic review of health economic models for assessment and diagnosis of dementia

INTRODUCTION: Timely diagnosis of dementia is a public health priority to enable risk modification and treatment access. This study systematically identifies and critically appraises health economic models of dementia assessment and diagnosis. METHODS: Inclusion criteria were: any dementia stage; evaluated strategy(ies) for initial assessment/diagnosis of dementia; health economic evaluation using decision modeling. Ten databases were searched for 2000–2024. Philips checklist was applied for quality assessment. Narrative synthesis appraised methodological features and issued decision‐making recommendations. RESULTS: Thirty‐two studies were included. Six evaluated cerebrospinal fluid (CSF); 11 neuroimaging including amyloid‐targeting positron emission tomography; three blood‐based biomarkers; two genetic testing; and 10 early assessment/diagnosis strategies. Methodological limitations included non‐consideration of capacity constraints. Decision‐making recommendations generally affirmed current clinical guidelines: for example, CSF to confirm Alzheimer's disease is cost‐effective (incremental cost‐effectiveness ratio of £10,150 per quality‐adjusted life‐year gained vs. no use). DISCUSSION: Methodological appraisal and decision‐making recommendations should assist model development and evidence‐based dementia diagnosis.