SPEECH BY DR AMY KHOR, SENIOR MINISTER OF STATE FOR HEALTH, AT THE 13TH INTERNATIONAL CONGRESS OF THE ASIAN SOCIETY AGAINST DEMENTIA, HELD ON THURSDAY 29 AUGUST 2019, AT THE SHANGRI-LA HOTEL SINGAPORE

Associate Professor Ng Wai Hoe, Medical Director, National Neuroscience Institute

Associate Professor, Christopher Chen, President, Asian Society Against Dementia

Associate Professor Nagaendran Kandiah, Chairman, 13th Congress of the Asian Society Against Dementia 

Distinguished guests and faculty

1. A very good morning to you. It is my pleasure to be here today at the Opening Ceremony of the 13th International Congress of the Asian Society Against Dementia and the 6th Singapore International Neuro-Cognitive Symposium. 

2. Today, one in 10 seniors who are aged 60 and above in Singapore has dementia.  Neurological diseases such as dementia are the fifth leading cause of disability in Singapore. With increased life expectancy and a rapidly ageing population, we expect the number of people with dementia to increase. It is therefore important to raise awareness of dementia and increase support for persons with dementia and their caregivers. 

3. The government’s strategy for dementia not only focuses on those already diagnosed with dementia but also on outreach efforts to increase awareness and early detection. The Ministry of Health (MOH) and Agency for Integrated Care (AIC) have worked with partner agencies to establish 39 community outreach teams, to reach out to persons with, or at-risk of dementia, as well as their caregivers. The teams provide information about the condition for early identification, and offer basic emotional support. As of December last year, over 210,000 people have been reached by these teams.   

Support for Dementia Research 

4. Beyond support for persons with dementia and their caregivers, research on dementia is important in helping us better understand the disease, targeting upstream prevention efforts, improving care, and informing policy development and service planning.

5. I am glad to see continued funding support for research in dementia. For example, the National Neuroscience Institute (NNI) has seen an increase of patients with Young Onset Dementia by 25% from 2017 to 2018. The National Medical Research Council (NMRC) awarded NNI a $1.7 million grant for research on Young Onset Dementia in Singapore so as to better understand the disease, which affects persons below 65 years old, and the unique needs of this population.  Insights from the study will be invaluable in the development of new care approaches or intervention strategies for people with Young Onset Dementia. 

Management of Vascular Risk Factors to Prevent Dementia

6. Moving care upstream towards preventive health in an ageing population like Singapore will help Singaporeans live well while living longer. Active preventive measures need to be taken earlier in life rather than later. Like most neurological diseases, there is no known cure for dementia. However, steps can be taken to prevent or delay the onset of dementia, slow down the progression of dementia, and better manage the effects of dementia. 

7. National Neuroscience Institute (NNI) has found that there is a high prevalence of chronic diseases such as hypertension and diabetes among Asian patients with mild cognitive impairment and dementia. Other studies have demonstrated a link between Type 2 Diabetes Mellitus and Alzheimer’s Disease (AD), with diabetic patients having a higher risk of developing AD. Hence, in order to prevent or delay the onset of dementia, vascular risk factors such as diabetes and hypertension should be detected early and controlled properly. NNI has developed a six-month training programme for primary care practitioners, to train them to better detect and treat dementia in its early stage, with an emphasis on the management of these risk factors. 

Community Phase of SMaRT

8. For those affected by dementia, strengthening dementia care support in the community is important to help them age in place. MOH has been working with partner agencies, healthcare institutions and community service providers to build up capacity and capability of dementia care service providers in the community to support persons with dementia as well as their caregivers. For example, eight Dementia-Friendly Communities (DFC) have been set up to build a more caring and inclusive society for persons with dementia and their caregivers so that they can continue to live at home in their community. MOH has also been expanding dementia day care services to support ageing in place, adding about 1,000 dementia day care places in 2018, to provide about 3,000 places island wide. The dementia day care services provide custodial service while engaging seniors in recreational activities and cognitive stimulation programmes.

9. I am glad to know that NNI is also extending their services into the community to better support persons with dementia. Today, I am happy to announce the launch of the Community Phase of the Temasek Foundation-NNI Stroke Memory Rehabilitation (SMaRT) programme.  The programme aims to prevent or delay the development of dementia in stroke patients by improving their cognition and daily function.  The pilot phase of the SMaRT programme introduced in 2017 at NNI benefited close to 200 patients and demonstrated significant improvement in cognition, mood, activities of daily living and overall quality of life for patients. After completion of the SMaRT programme, close to 60% of the participants reported a major improvement in planning abilities and undertaking activities of daily living without requiring any assistance. Such encouraging results have led to the development of the community phase of the SMaRT programme to improve care delivery by rehabilitating more post-stroke patients at risk of developing dementia. 

10. NNI will be working with up to five senior care centres island-wide to conduct the SMaRT programme for post-stroke individuals at risk of developing dementia, and targeting to enrol close to 1000 participants over the next year. With a highly targeted cognitive care curriculum that involves memory training and activities that enhance planning and problem-solving abilities, SMaRT hopes to improve the patient’s quality of life and reduce caregiver stress by maintaining the patient’s daily functions.   

Closing 

11. The exchange of knowledge and best practices among professionals and researchers from various disciplines at this Congress is essential as we look for ways to collaborate on dementia research and better care for persons with dementia. I hope that you will have a fruitful time sharing ideas and forging new partnerships to improve dementia care for patients for years to come.  

12. With this, I am pleased to launch the 13th International Congress of the Asian Society Against Dementia and 6th Singapore International Neuro-Cognitive Symposium. I wish you all a successful and enriching Congress.