Economic Costs of Dementia in Low and Middle Income Countries
The aim of the study is to assess the impact of dementia in low and middle income countries (LAMICs) on service and family costs and to assess the impact of dependency and other factors on costs. A prevalence-based bottom up cost-of-illness study was carried out using the database of the 10/66 dementia project in seven LAMICs (11sites, n=15,022). The total cost was divided into cost of medical care, informal care and paid home care. The perspective of costs included both the public and private level. Cost of medical care at the private level was the out-of-pocket expenses. Health service use was valued according to country specific unit cost based on UK unit costs and WHO-CHOICE ratios. Cost of informal care at the private level was valued based on real salary loss and on average wages at the public level. Regression models were used to identify predictors of cost and attributable costs of dementia. The results showed that the average total costs for people with dementia were I$1887 at the private level and I$6750 at the public level. At the public level, 94% of total costs were due to social care, and 90.4% of social care costs were due to informal care. Physical impairment and Behavioural and psychological symptoms of dementia (BPSD) led to higher costs of informal care, but not for medical care. Average attributable costs of dementia were I$5164, and were higher than for depression and other chronic diseases. Costs increased with dementia severity. Estimates of total dementia costs are substantial and most of the care is due to support from unpaid family members. Interventions should be introduced both for dementia patients and their carers in the early stages of the condition dementia, so as to decrease the cost as well as improving quality of life.
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