Policy making increasingly needs cost-effectiveness evidence to inform resource allocation. The objective of this review is to identify and to investigate evidence evaluating the cost-effectiveness of interventions aimed to support adult carers, drawing on the National Institute for Health and Care guideline on Supporting Adult Carers.

The protocol of the review was aimed to identify the economic studies published from 2003 onwards on all types of interventions for supporting adult carers. The applicability to the review and methodological quality of included economic evaluations were assessed using pre-established checklists specified in the National Institute for Health and Care (NICE) manual for developing guidelines.

Our search yielded 10 economic evaluations. The main types of strategies evaluated were psychological and emotional support, training, and education support interventions. We found that the interventions more likely to be cost-effective were usually tailored to the specific carers’ circumstances and delivered face-to-face and were multi-component in nature, including elements of psycho-education, training, psychological and practical support. The narrative synthesis of results indicated a wide variation in cost-effectiveness findings and methodological quality.

This article indicates that systematic reviews of economic evaluations can be considered as an appropriate means to support decision makers in allocating health and social care resources. Given the high economic and social impact of unpaid caring, and based on the research gaps identified, we recommend that future economics research should be targeted on interventions for identifying carers; and programs for providing carers with support and advice to help them to enter, remain in or return to paid work.

To investigate potential risk factors for mild behavioral impairment (MBI) among non-demented geriatrics.

Population-based, cross-sectional survey.

Taiwan Alzheimer Disease Association (TADA) Database.

Participants were selected by multistage random sampling of all Taiwan counties. They received in-person interviews between December 2011 and March 2013.

Demographic data, lifestyle and habits, medical comorbidities, cognitive status measured by the Taiwanese Mini-Mental Status Examination (TMSE) and presence of MCI of the participants were collected. Subjects were distributed to the MBI and non-MBI groups. These factors had been evaluated for their effects on MBI in the univariate and multivariable logistic regression models.

In total, 6,196 non-demented participants aged 65 years or older, including 409 MBI and 5,787 non-MBI participants, were recruited. After adjustment for age, sex, education, body mass index, lifestyle and habits, medical comorbidities, and MCI, good sleep was associated with lower risk of MBI (OR 0.09, 95% CI 0.07 – 0.12). Low body weight (OR 2.01, 95% CI 1.21–3.33), low-to-medium education (OR 1.40, 95%CI 1.06–1.85; OR 2.32, 95% CI 1.67–3.21), medical comorbidities of hypertension (OR 1.56, 95% CI 1.25–1.95), hyperlipidemia (OR 1.29, 95% CI 1.00–1.67), cancer (OR 2.05, 95% CI 1.37–3.06) were significantly associated with increased MBI risk. MCI neither increased nor decreased risk of MBI (OR 1.00, 95% CI 0.76–1.32).

Good sleep was associated with lower MBI risk. Underweight, lower education, medical comorbidities of cancer, hypertension, hyperlipidemia were predictive of MBI.