The worldwide costs of dementia in 2019

Introduction: Dementia is a leading cause of death and disability globally. Estimating total societal costs demonstrates the wide impact of dementia and its main direct and indirect economic components. Methods: We constructed a global cost model for dementia, presenting costs as cumulated global and regional costs. Results: In 2019, the annual global societal costs of dementia were estimated at US $1313.4 billion for 55.2 million people with dementia, corresponding to US$23,796 per person with dementia. Of the total, US $213.2 billion (16$448.7 billion (34%) direct social sector costs (including long-term care), and US $651.4 billion (50$1313.4 in 2019. Sixty-one percent of people with dementia live in low-and middle-income countries, whereas 74% of the costs occur in high-income countries. The impact of informal care accounts for about 50% of the global costs. The development of a long-term care infrastructure is a great challenge for low-and middle-income countries. There is a great need for more cost studies, particularly in low- and middle-income countries. Discussions of a framework for global cost comparisons are needed

Fardeau socio-économique des démences chez les personnes âgées en Afrique sub-Saharienne: cas du Bénin

This thesis aimed to improve knowledge on the socioeconomic burden of dementia in sub- Saharan Africa. To achieve this objective, we conducted a situational analysis of dementia care in the country, followed by a survey of elderly people and their caregivers. There is no specific plan to address dementia in Benin nor a formal long-term care system. However, several health structures across the country offer dementia diagnosis and monitoring. Data were collected from 135 people aged 73 years on average, 50% of whom had mild-to-severe dementia. The results revealed that dementias place considerable demands on caregiving, primarily on women, who represent 70% of caregivers. The average annual cost of caring for people with dementia is estimated at $2,400 PPP. Informal care accounted for 92$PPA. Les soins informels représentant 92% de ce coût total. Le volume d’aide pouvant atteindre huit heures par jour. La qualité de vie globale rapportée était bonne, avec des variations observées entre les participants ruraux et urbains dans différents domaines. Le fardeau des aidants était relativement faible, avec des préoccupations principalement axées sur l'amélioration de la prestation des soins, l'incertitude quant à l'avenir et les sentiments d'inadéquation. Les facteurs associés au fardeau des aidants comprenaient le niveau d'invalidité des personnes âgées, le statut socio-économique et la qualité de vie des bénéficiaires des soins

Fardeau socio-économique des démences chez les personnes âgées en Afrique sub-saharienne : cas du Bénin

This thesis aimed to improve knowledge on the socioeconomic burden of dementia in sub-Saharan Africa. To achieve this objective, we conducted a situational analysis of dementia care in the country, followed by a survey of elderly people and their caregivers. There is no specific plan to combat dementia in Benin or in a formal long-term care system. However, several health structures across the country offer dementia diagnosis and monitoring. Data were collected from 135 people aged 73 years on average, 50% of whom had mild-to-severe dementia. The results revealed that dementias place considerable demands on caregiving, primarily on women, who represent 70% of caregivers. The average annual cost of caring for people with dementia is estimated at 2,400 dollars PPP. Informal care accounted for 92% of the total cost. The volume of help could reach eight hours per day. The overall reported quality of life was good, with variations observed between the rural and urban participants in different areas. The caregiver burden was relatively low, with concerns primarily focused on improving caregiving, uncertainty about the future, and feelings of inadequacy. Factors associated with caregiver burden included the disability level of older adults, socioeconomic status, and the quality of life of care recipients.Cette thèse visait à améliorer les connaissances sur le fardeau socioéconomique des démences en Afrique subsaharienne. Pour atteindre cet objectif, nous avons réalisé au Bénin une analyse situationnelle de la prise en charge des démences dans le pays, puis une enquête auprès des personnes âgées et leurs aidants. Il n'existe pas encore au Bénin de plan spécifique de lutte contre les démences, ni de système formel de soins de longue durée. Néanmoins, plusieurs structures sanitaires à travers le pays proposent des services de diagnostic et suivi des démences. Les données recueillies auprès de 135 personnes âgées de 73 ans en moyenne, dont 50% présentaient une démence légère à sévère. Les résultats ont révélé que les démences imposent des exigences considérables en matière de soins, principalement aux femmes qui représentent 70% des aidants. Le coût annuel moyen des soins aux personnes atteintes de démences était estimé à 2 400 dollars PPA. Les soins informels représentant 92 % de ce coût total. Le volume d'aide pouvant atteindre huit heures par jour. La qualité de vie globale rapportée était bonne, avec des variations observées entre les participants ruraux et urbains dans différents domaines. Le fardeau des aidants était relativement faible, avec des préoccupations principalement axées sur l'amélioration de la prestation des soins, l'incertitude quant à l'avenir et les sentiments d'inadéquation. Les facteurs associés au fardeau des aidants comprenaient le niveau d'invalidité des personnes âgées, le statut socio-économique et la qualité de vie des bénéficiaires des soins

Socio-economic burden of dementia in the elderly in sub-Saharan Africa : The case of Benin

Cette thèse visait à améliorer les connaissances sur le fardeau socioéconomique des démences en Afrique subsaharienne. Pour atteindre cet objectif, nous avons réalisé au Bénin une analyse situationnelle de la prise en charge des démences dans le pays, puis une enquête auprès des personnes âgées et leurs aidants. Il n'existe pas encore au Bénin de plan spécifique de lutte contre les démences, ni de système formel de soins de longue durée. Néanmoins, plusieurs structures sanitaires à travers le pays proposent des services de diagnostic et suivi des démences. Les données recueillies auprès de 135 personnes âgées de 73 ans en moyenne, dont 50% présentaient une démence légère à sévère. Les résultats ont révélé que les démences imposent des exigences considérables en matière de soins, principalement aux femmes qui représentent 70% des aidants. Le coût annuel moyen des soins aux personnes atteintes de démences était estimé à 2 400 $PPA. Les soins informels représentant 92$2,400 PPP. Informal care accounted for 92% of the total cost. The volume of help could reach eight hours per day. The overall reported quality of life was good, with variations observed between the rural and urban participants in different areas. The caregiver burden was relatively low, with concerns primarily focused on improving caregiving, uncertainty about the future, and feelings of inadequacy. Factors associated with caregiver burden included the disability level of older adults, socioeconomic status, and the quality of life of care recipients

Fardeau socio-économique des démences chez les personnes âgées en Afrique sub-Saharienne: cas du Bénin

This thesis aimed to improve knowledge on the socioeconomic burden of dementia in sub- Saharan Africa. To achieve this objective, we conducted a situational analysis of dementia care in the country, followed by a survey of elderly people and their caregivers. There is no specific plan to address dementia in Benin nor a formal long-term care system. However, several health structures across the country offer dementia diagnosis and monitoring. Data were collected from 135 people aged 73 years on average, 50% of whom had mild-to-severe dementia. The results revealed that dementias place considerable demands on caregiving, primarily on women, who represent 70% of caregivers. The average annual cost of caring for people with dementia is estimated at $2,400 PPP. Informal care accounted for 92$PPA. Les soins informels représentant 92% de ce coût total. Le volume d’aide pouvant atteindre huit heures par jour. La qualité de vie globale rapportée était bonne, avec des variations observées entre les participants ruraux et urbains dans différents domaines. Le fardeau des aidants était relativement faible, avec des préoccupations principalement axées sur l'amélioration de la prestation des soins, l'incertitude quant à l'avenir et les sentiments d'inadéquation. Les facteurs associés au fardeau des aidants comprenaient le niveau d'invalidité des personnes âgées, le statut socio-économique et la qualité de vie des bénéficiaires des soins

Fardeau socio-économique des démences chez les personnes âgées en Afrique sub-saharienne : cas du Bénin

This thesis aimed to improve knowledge on the socioeconomic burden of dementia in sub-Saharan Africa. To achieve this objective, we conducted a situational analysis of dementia care in the country, followed by a survey of elderly people and their caregivers. There is no specific plan to combat dementia in Benin or in a formal long-term care system. However, several health structures across the country offer dementia diagnosis and monitoring. Data were collected from 135 people aged 73 years on average, 50% of whom had mild-to-severe dementia. The results revealed that dementias place considerable demands on caregiving, primarily on women, who represent 70% of caregivers. The average annual cost of caring for people with dementia is estimated at $2,400 PPP. Informal care accounted for 92$ PPA. Les soins informels représentant 92 % de ce coût total. Le volume d'aide pouvant atteindre huit heures par jour. La qualité de vie globale rapportée était bonne, avec des variations observées entre les participants ruraux et urbains dans différents domaines. Le fardeau des aidants était relativement faible, avec des préoccupations principalement axées sur l'amélioration de la prestation des soins, l'incertitude quant à l'avenir et les sentiments d'inadéquation. Les facteurs associés au fardeau des aidants comprenaient le niveau d'invalidité des personnes âgées, le statut socio-économique et la qualité de vie des bénéficiaires des soins

Epidemiology of chronic obstructive pulmonary disease in the global HIV-infected population: a systematic review and meta-analysis protocol

Abstract Background Evidence suggests a relationship between human immunodeficiency virus (HIV) infection and chronic obstructive pulmonary disease (COPD). Although the high burden of COPD and the HIV disease is clearly demonstrated, to the best of our knowledge, there is a lack of summary and meta-analysis data on the epidemiology of COPD in the global HIV-infected population to date. The present protocol for a systematic review and meta-analysis intends to summarize existing data on the prevalence, incidence, and risk factors of COPD in the global HIV-infected population. Methods and design The present review will include cohort, cross-sectional, and case-control studies conducted among HIV infected people, which report prevalence, incidence, and factors associated with COPD or enough data for their estimation. We will consider published and unpublished studies in English and French language, regardless of geographical location. Relevant records will be searched using PubMed/Medline, and Scopus from inception to December 31st, 2016. Reference lists of eligible papers and relevant review articles will be screened. Two investigators will independently screen, select studies, and extract data, with discrepancies resolved by consensus or arbitrarily by a third investigator. Risk of bias and methodological quality of the included studies will be assessed using the Newcastle-Ottawa Scale. Funnel-plots and Egger’s test will be used to determine publication bias. The study-specific estimates will be pooled through a random-effects meta-analysis model to obtain an overall summary estimate. To keep the effect of studies with extremely small or extremely large estimates on the overall estimate to a minimum, the variance of the study-specific prevalence/incidence will be stabilized with the Freeman-Tukey single arc-sine transformation. The heterogeneity will be evaluated by the χ2 test on Cochrane’s Q statistic. Results will be presented by geographic region and by antiretroviral therapy status. We plan to summarize data on factors associated with COPD in narrative format. Discussion This systematic review and meta-analysis will give an overview of the epidemiology of COPD in the global HIV population to inform policy-makers and to provide accurate data that can underpin effective interventions for optimizing their detection and management. Systematic review registration PROSPERO CRD42016052639

Costs of dementia in low-and-middle income countries: a systematic review

International audienceObjective: To review studies conducted on the costs of dementia in low- and middle-income countries (LMICs), describe their methodology and summarize costsestimates.Methods: We conducted a systematic review, searching in bibliographic databases in health, economics and social sciences, and main grey literature resources. Publications were evaluated by two independent investigators, conflict discussed, and the final decision taken by a third investigator. We included all studies presenting costs of any aspect of dementia care.Results: Overall, 6,843 title and abstract, then 74 full texts articles evaluated. Finally, 15 single studies were included. Those were from only 9 out of the 156 LMICs: China (6); Brazil (2); and one from Argentina, Colombia, Iran, Peru, Romania, Thailand and Turkey. No study was from Africa. Studies focused mainly on Alzheimer’s disease. Studies investigated all three categories of cost-of-illness i.e., medical, social and informal care costs, but items, data collection and definitions in each category were highly variable. Dementia costs tend to increase with the severity of the disease with greater medical costs in the mild stage and higher social and informal care costs in the moderate and severe stages. Costs estimates varied widely: from $327.4 to$1,266.3 for annual medical costs, from $112.4 to$5,575.0 for social costs; and costs from $324.0 to$10,031.1 for informal care. Overall, dementia care cost up to $19,101 per year for a single patient, usually at the charge of families.Conclusion: Limited studies have been conducted on dementia costs in LMICs, with none so far in Africa. It appears urgent to provide accurate evidence of the disease burden in the region to guide public health policies

High costs of dementia informal care in low-and middle-income countries

International audienceBackground: Worldwide, around 50 million people live with dementia, of whom 58% live in low- and middle-income countries (LMICs). It is estimated that 84% of those older adults live with their families. In 2015 global dementia costs were estimated at $818 billion. With 40$145 to $6,926 in mild ; from$453 to $8,872 in moderate; from$521 to $20,076 in severe dementia.Conclusion: Very few studies have been conducted on dementia costs across LMICs, with none so far in Africa. Meanwhile dementia is a major public health problem, it appears urgent to investigate its burden on families to guide health resources allocation

Dementia care system in a West African country : Bénin

International audienc