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Area All 382 Care, carers and services 140 Medicines 85 Genes (not modifiable) 35 All modifiable factors together 27 Diet and supplements 23 Exercise and activity 21 Sleep, mood and social life 19 Hearing and vision 8 Alcohol, tobacco and cannabis 6 Infection and vaccination 5 Heart and metabolic health 4 Injury, delirium and falls 4 Environment 3 Cognitive activity 2

Question Both Prevention 190 Treatment 192

Direction Any Benefit 144 Harm 105 No effect 38 Mixed 37 No direction reported 58

Design Any meta-analysis 57 randomised trial 44 phase 3 trial 15 systematic review 9 phase 2 trial 10 cohort study 136 phase 1 trial 2 cross-sectional study 31 case-control study 14 modelling study 20 regulatory decision 7 company announcement 1 coverage determination 1 None 35

Showing 4 of 382 rows for Health-system and payment model. One row per study per exposure: a study that tested two different things appears twice, once for each.

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Research and outcomes, 4 rows. Every row links to its source.
Exposure	Question	Direction	Outcome measured	Design	People	Effect size, as the source reported it	Source
Health-system and payment model Care, carers and services	Treatment	No effect why Difference-in-differences around ACO entry found no change in end-of-life care processes, outcomes or spending.	Hospice use and end-of-life spending	cohort study	162,034	Hospice use difference -0.4 percentage points (95% CI -1.4 to 0.5); last-6-months spending -$632 (95% CI -$1,377 to $113)	JAMA Health Forum 2025 ✓ Peer-reviewed PMID 40343716
Health-system and payment model Care, carers and services	Treatment	No direction reported why A single-programme implementation report with no comparison group. It counts enrolment and service use and estimates no effect.	Enrolment, respite use and disenrolment in the first year of one GUIDE programme	cohort study	158	Over 35% of eligible beneficiaries have utilized respite services. Approximately 9% have disenrolled, the majority (64%) expired/hospice	Innovation in Aging (GSA 2025 conference abstract) 2025 ⚠ Conference abstract — not peer-reviewed DOI 10.1093/geroni/igaf122.3561
Health-system and payment model Care, carers and services	Treatment	No direction reported why Implementation guidance drawn from six earlier comprehensive dementia care programmes. It reports no effect estimate of its own.	None measured (implementation guidance)	None	not stated	not established — guidance article; the abstract reports no data. the library's "up to 20% of emergency department visits ... avoidable" is a cited statistic not in…	Journal of the American Geriatrics Society 2025 ✓ Peer-reviewed PMID 41170936
Health-system and payment model Care, carers and services	Treatment	Benefit why Direction is for the benefit redesign: projected out-of-pocket drug spending fell 55% ($56 to $25) for low-income-subsidy beneficiaries and 25% ($772 to $576) for others, with larger reductions for people with 6-8 comorbidities.	Simulated annual out-of-pocket drug spending for Medicare beneficiaries with dementia under the 2025 Part D cost-sharing rules	modelling study	1,677	we project average annual OOP drug expenditures among LIS beneficiaries with dementia to decrease from $56 to $25-representing a $31, or 55%, reduction. In contrast, among non-LIS beneficiaries, average OOP drug expenditures is projected to decrease from $772 to $576, a $196, or 25% reduction	Value in Health 2025 ✓ Peer-reviewed PMID 39880200

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