Research Article: An assessment of direct and indirect costs of dementia in Brazil

Date Published: March 1, 2018

Publisher: Public Library of Science

Author(s): Ceres Ferretti, Flávia M. Sarti, Ricardo Nitrini, Fernando F. Ferreira, Sonia M. D. Brucki, Bruce A. Larson.


To analyze costs associated with dementia based on a cross-sectional study in the Brazilian health system.

Direct and indirect costs were estimated by conducting comprehensive interviews on the use of resources in a sample of 156 patients with dementia treated at an outpatient memory clinic of a tertiary hospital. A regression model was used to determine the main determinants of costs associated with dementia.

Global costs of dementia were US$1,012.35; US$1,683.18 and US$1,372.30 per patient/month for mild, moderate and severe stages, respectively. Indirect costs ranged from US$536.62 to US$545.17 according to severity. Dementia costs were influenced by medication, FAST score, and educational level of caregiver.

The study represents an original contribution toward establishing direct and indirect costs of dementia in Brazil. Results indicate significant economic impacts, including projection of annual costs of US$16,548.24 per patient.

Partial Text

Recent estimates of the prevalence of dementia and Alzheimer’s disease (AD) have risen dramatically around the world, increasing from 47.47 million individuals in 2015 to a predicted 75.63 million in 2030 and 135.46 million in 2050 [1]. In Latin America (LA) as a whole, the number of patients with dementia was approximately 3 million in 2010, with Brazil accounting for over 1 million cases [2,3]. Evidence shows variations in prevalence according to region of the country, although 12% is the currently accepted rate [4–6].

One hundred and fifty-six interview protocols were performed with informal caregivers of outpatients with dementia, categorized according to severity into mild (n = 61), moderate (n = 74) and severe (n = 21) stages of the disease. Five protocols were excluded: one due to missing information and four to duplicate interviews where, in these cases, only data from the latest interview were considered for the data analysis.

The majority of dementia patients have AD (65%) worldwide [1], where an AD prevalence of 68% was detected in the present study sample recruited from a tertiary outpatient memory clinic in Brazil. Regardless of type of dementia, there are numerous concerns over projections of incidence in UMICs, particularly the ageing process. Life expectancy in Brazil has increased in the last few decades, with future increases in the risk of dementia expected [12].




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