Social return on investment of home exercise and community referral for people with early dementia

Abstract Background Exercise can improve physical function and slow the progression of dementia. However, uncertainty exists around the cost-effectiveness of exercise programmes for people with early dementia. Objective The aim is to determine whether a home-based supervised exercise programme (PrAISED – promoting activity, independence, and stability in early dementia) can generate a positive social return on investment (SROI). Methods SROI was conducted as part of a randomised controlled feasibility trial comparing PrAISED with usual care. Wellbeing valuation was used to compare the costs of the programme with the monetised benefits to participants, carers, and healthcare service providers. Results The PrAISED programme generated SROI ratios ranging from £3.46 to £5.94 for every £1 invested. Social value was created from improved physical activity, increased confidence, more social connection and PrAISED participants using healthcare services less often than usual care. Conclusion Home-based supervised exercise programmes can generate a positive SROI for people with early dementia. Trial registration ClinicalTrials.gov: NCT02874300 (first posted 22nd August 2016), ISRCTN: 10550694 (date assigned 31st August 2016)