Indirect cost with dementia: A Brazilian study

Abstract

Costs with dementia have been the focus of research around the world and indirect costs to the caregiver appear in the literature as responsible for the greatest impact. In Latin American (LA) studies, indirect costs with dementia range from 60% to 75% of family income.ObjectiveTo present preliminary results of the study "Description of the methods and cost analysis with dementia" currently being conducted at the Behavioral and Cognitive Neurology Unit of Hospital de Clínicas of University of São Paulo - HC-FMUSP.MethodsA cross-sectional study which, to date, includes interviews of 93 primary caregivers. The research protocol includes a sociodemographic questionnaire, the Functional Assessment Staging (FAST) scale, the Burden Interview (Zarit), an economic classification scale, and the Resource Utilization in Dementia (RUD) scale.ResultsMonthly indirect costs were US$ 1,122.40, US$ 1,508.90 and US$ 1,644.70 stratified into mild, moderate and severe dementia, respectively. The projected annual indirect costs were US$ 13,468.80, US$ 18,106.80 and US$ 19,736.40, representing 69 to 169% of family income.ConclusionThis small sample showed that the impact of indirect costs with dementia in Brazil may be higher than that reported in other Latin American (LA) studies. These initial results may represent an important contribution for further research on costs with dementia in LA.

An assessment of direct and indirect costs of dementia in Brazil

“…Demographic data on patients and caregivers regarding age and gender proved similar to the findings of other studies conducted in LA [ 1 , 12 , 16 ] and in high-income countries (HICs) [ 1 , 24 ]. Patients and caregivers interviewed in the present study were younger in comparison to other studies conducted in HICs (72.9 years versus ≥75 years, and 54 years versus 65 years, respectively), and in Brazil (42.1 years) [ 3 , 25 – 28 ]; however, it was consistent with the previous study performed using subsample of the research [ 14 ]. Most patients and caregivers were female, and a higher percentage of retirees was observed among the patients in comparison to other studies [ 3 , 14 ].…”

“…Considering the lack of evidences on dementia costs in Brazil, a previous study was published presenting preliminary findings of the research project referring to indirect costs of dementia in Brazil [ 14 ], including a fraction of the planned sample regarding data from caregivers.…”

“…Clinical data included variables related to disease progression and comorbidities of the patients and their respective caregivers. Detailed information on the research protocol is available within a study published with preliminary results of the research, referring to indirect costs of dementia in Brazil, including a fraction of the planned sample regarding data from caregivers [ 14 ].…”

“…The calculation of monthly hours related to activities of daily living (ADL), instrumental activities of daily living (IADL) and supervision of the patient was made using previously tested methodology [ 14 ].…”

“…The onset of dementia compromises patient quality of life, family relationships, and productivity of patients’ relatives and caregivers. Based on epidemiological data [ 1 , 2 ], governments worldwide are discussing the need for health policies related to dementia, to ensure provision of adequate care and support to patients diagnosed with dementia and to their respective caregivers [ 10 , 14 – 16 ].…”