Supplementary Material for: Informal care time and costs of dementia care in Benin (West Africa)

Background: Dementia is a growing global health challenge, with significant socioeconomic implications. This study examined the informal care duration and related costs along with the total cost of care for older individuals with dementia in Benin, West Africa, providing insights into a region with limited dementia research. Methods: We conducted a cost-of-illness study in Benin. Both hospital and community recruitments were used to enroll adults aged ≥ 60 years and their primary caregivers. Structured questionnaire and validated tools were used to collect the demographic, clinical, healthcare resource utilization data as well as informal care duration. Replacement costs approach was performed to valuate informal care time. Official exchange rates from the World Bank were used to convert costs from local currency to purchasing power parities dollars (PPP$). Results: Data from 135 individuals with varying dementia stages revealed that dementia places substantial caregiving demands, predominantly on women who provide up to eight hours of daily care. In 2021, the mean annual cost of dementia care was estimated to be PPP$2,399.66 ± 2,057.07. Informal care represented a significant portion of dementia expenses, up to 92% of the total care costs in this study. Discussion: Policy interventions are urgently needed to address the dementia-care challenges in Benin, especially because economic transitions and educational advancements may reduce the availability of informal caregivers. This emphasizes the vital role of informal caregivers and underscores the need of implementing dementia policies to support families facing the evolving challenges of dementia care.

研究背景：痴呆症已成为日益严峻的全球公共卫生挑战，兼具重大社会经济影响。本研究针对西非贝宁地区的痴呆老年患者，探究了其非正式照护（informal care）时长、相关成本及总照护成本，为这一痴呆研究相对匮乏的地区提供了重要参考。
研究方法：本研究在贝宁开展了疾病成本研究。通过医院与社区两种招募渠道，招募60岁及以上的痴呆老年患者及其主要照护者。采用结构化问卷与经过信效度验证的研究工具，收集受试者的人口学特征、临床资料、医疗资源使用情况及非正式照护时长数据。采用重置成本法对非正式照护时间进行估值，使用世界银行公布的官方汇率将本地货币核算的成本转换为购买力平价美元（PPP$）。
研究结果：对135名不同痴呆分期患者的数据分析显示，痴呆症带来了沉重的照护负担，且主要由女性照护者承担，她们每日照护时长可达8小时。2021年，痴呆照护的年均成本估算为PPP$2,399.66 ± 2,057.07。非正式照护占痴呆照护总支出的比例极高，本研究中其占比可达总照护成本的92%。
讨论：贝宁地区亟需出台政策干预措施以应对痴呆照护面临的挑战，尤其是考虑到经济转型与教育水平提升可能会减少非正式照护者的供给。这凸显了非正式照护者的关键作用，也强调了需制定痴呆照护相关政策，以支持面临不断变化的痴呆照护难题的家庭。