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ToolsBracci, Ella L., Davis, Courtney R., Meyer, Denny, Kingsley, Michael, Breckon, Jeff, Minihane, Anne Marie, Itsiopoulos, Catherine, Macpherson, Helen, Scholey, Andrew, Davison, Kade, Dyer, Kathryn A., Kennedy, Greg, Pipingas, Andrew, Murphy, Karen J. and Segal, Leonie (2025) 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 randomised controlled trial. British Journal of Nutrition, 134 (12). pp. 969-978. ISSN 0007-1145
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Abstract
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-randomised Mediterranean diet (MedDiet) and walking controlled trial (MedWalk) was undertaken. In addition, QoL data were analysed. Programme costs ($AUD2024) covered staff to deliver the MedWalk programme 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 cross-tabulation test. MedWalk programme costs were estimated at $2695 AUD per participant and control group cost at $165 per person-a differential cost of $2530. Mean change in utility scores from baseline to 12 months was not statistically significant between groups. Nevertheless, the MedWalk group was significantly less likely to experience a reduction in their QoL (20·3 % MedWalk v. 42·6 % control group) (P = 0·020). 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.
| Item Type: | Article |
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| Additional Information: | Acknowledgements The authors would like to acknowledge the wider MedWalk collaborative team of associate investigators, scientific committee members and the data safety monitoring board who were involved in the conception and implementation of the MedWalk trial. The authors would also like to thank the following organisations, their retirement villages, staff and residents for access to facilities, advice and assistance with the trial: in South Australia – ECH (Cumberland Park Community Group and Rotary), Karidis (Acacia Park), Lendlease (Vermont), LifeCare (Marion Rose), Retire Australia (Glengowrie, Tea Tree Gardens and Torrens Grove), RSL Care (Sturt) and Southern Cross (Riverpoint and The Pines); and in Victoria – Abound Communities (Rushall Park and Leith Park), Australian Unity (Campbell Place and Peninsula Grange) and Villa Maria Catholic Homes (St Joseph Mews and Athelstan). Additionally, the authors acknowledge the contributions to data collection by Jessie Clark, Emily Eversteyn, Bethany Murphy-Aird, Mahima Bedi, Mee Chee Chong, Nicole Echeverria, Gabriella Inguanti, Ashlee Harvey, Kasia Main, Laura Martin, Janis Onuzans, Melissa Rubin, Mahima Shah, Tania Thodis and Nerylee Watson. The authors would also like to acknowledge contributions from the following organisations: Cobram Estate for providing Australian extra virgin olive oil gratis to trial participants; SanRemo for providing whole meal pasta and couscous; Hoyts for providing herbs and spices and The Almond Board of Australia for providing almonds. K. J. M., L. S., E. L. B., C.R.D, and K. A. D. conceived the MedWalk substudy; L. S., E. L. B., K. A. D., K. J. M. and C. R. D. planned the methodology; E. L. B. and L. S. completed the cost analyses; ELB drafted the manuscript. All authors have critically revised the manuscript and have approved the final version for publication. The authors declare no conflicts of interest This study was conducted according to the guidelines laid down in the Declaration of Helsinki, and all procedures involving human subjects/patients were approved by the Human Research Ethics Committee at Swinburne University (ref: 20201600–3559, 14/02/2020) and The University of South Australia (ref: 202844, 16/06/2020). Written informed consent was obtained from all subjects/patients. This trial was registered with the Australia and New Zealand Clinical Trials Registry at https://www.anzctr.org.au/ (ANZCTR 12620000978965). Data supporting the analyses and results of this paper are available from the corresponding author upon reasonable request. |
| Uncontrolled Keywords: | cost–consequence analysis,mediterranean diet,physical activity,quality of life,walking intervention,medicine (miscellaneous),nutrition and dietetics ,/dk/atira/pure/subjectarea/asjc/2700/2701 |
| Faculty \ School: | Faculty of Medicine and Health Sciences > Norwich Medical School |
| UEA Research Groups: | Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging Faculty of Medicine and Health Sciences > Research Groups > Nutrition and Preventive Medicine Faculty of Medicine and Health Sciences > Research Groups > Cardiovascular and Metabolic Health Faculty of Medicine and Health Sciences > Research Centres > Metabolic Health |
| Related URLs: | |
| Depositing User: | LivePure Connector |
| Date Deposited: | 19 May 2026 13:30 |
| Last Modified: | 19 May 2026 13:30 |
| URI: | https://ueaeprints.uea.ac.uk/id/eprint/103102 |
| DOI: | 10.1017/S0007114525105333 |
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