SPEECH BY ASSOCIATE PROFESSOR KENNETH MAK, DIRECTOR OF MEDICAL SERVICES, MINISTRY OF HEALTH AND MEMBER, LEE KONG CHIAN SCHOOL OF MEDICINE GOVERNING BOARD, AT THE LAUNCH OF THE DEMENTIA RESEARCH CENTRE SINGAPORE, 25 APRIL 2022, 10.30AM

Professor Subra Suresh, President & Distinguished University Professor, NTU Singapore

Professor Joseph Sung, Distinguished University Professor, Dean, Lee Kong Chian School of Medicine and Senior Vice-President (Health & Life Sciences), NTU

Ladies and gentlemen,

1.     Good morning. It is my pleasure to join you at the launch of the Lee Kong Chian School of Medicine’s (LKCMedicine) Dementia Research Centre Singapore (DRCS).  The ongoing efforts to tackle dementia 

2.     As had been shared, around one in 10 people aged 60 and above in Singapore suffers from dementia. With Singapore’s increasing life expectancy and rapidly ageing population, the number of persons living with dementia is expected to continue to rise. This will have a significant impact not only on the persons living with dementia and their caregivers, but also on our healthcare system, in terms of cost, morbidity and mortality.  

3.     The Ministry of Health (MOH) adopts a multipronged approach to dementia care, which includes raising awareness of dementia, enhancing care capacity and capability in the community as well as in the hospitals, and supporting caregivers of persons living with dementia.  

4.     For example, the Health Promotion Board (HPB) conducted a vascular dementia campaign between May and July 2021, to reach out to Singaporeans aged 50 years and above, educate them on vascular dementia, including its common signs and symptoms, ways to prevent or delay its onset, and the need to seek professional help early. A post campaign evaluation conducted among 600 seniors aged 50 to 74 years old found that 3 in 4 (76%) seniors became more aware of the signs of vascular dementia, as compared to 1 in 4 (26%) before the campaign was conducted. HPB also provides a dedicated Dementia infoline and resources such as MindSG for the general public to find out more about dementia. 

5.     Project Pensieve is an initiative undertaken by a research team at the Singapore General Hospital (SGH) that could enable the earlier detection of dementia among seniors who are at risk of the disease. Many of our seniors with dementia and their caregivers are not aware of the condition until a more advanced stage of the disease occurs and they missed the opportunity of early intervention. By tapping on local clinical and technology expertise, the inter-agency team behind Project Pensieve has developed a digital drawing test that takes as little as 10 minutes to estimate the risk of dementia. This test uses shapes and symbols and is not affected by the language skills of the patient, and can be administered by volunteers and non-clinical staff. Artificial Intelligence is then used to analyse how the shapes and symbols are being drawn. While this project is still in the research phase, it holds great potential to benefit many seniors living with dementia through an earlier diagnosis. 

6.     For persons newly diagnosed with dementia and their caregivers, the Agency for Integrated Care (AIC) has worked with social service agency partners to implement the Post Diagnostic Support (PDS) pilot to strengthen support services. The pilot proactively equips persons with dementia and their caregivers with information, support, an individualised care plan and tools to ease their confusion. A sense of helplessness often faced upon diagnosis of the condition. Caregivers will also be connected to a caregiver peer network to provide them with social and emotional support. 

7.     While dementia is not a new disease, much remains to be known about the condition, especially how it can further inform our national strategies and efforts. It is therefore timely that LKCMedicine sets up a centre dedicated to multidisciplinary translational research on this condition. How DRCS plans to contribute to the efforts against dementia 

8.     DRCS will have a strong focus on early stage dementia and developing innovative solutions. The Centre also aims to use artificial intelligence (AI) and other digital technologies to find new strategies for dementia prevention and treatment. This will allow the Centre to make new findings and uncover novel perspectives on delaying the progression of Alzheimer’s disease, vascular dementia and other related conditions. There is evidence that an early diagnosis of dementia potentially offers the opportunity for early interventions that slow down or lessen the disease process, implementation of coordinated care plans while the patient is still competent to do so, better management of symptoms, and postponement of institutionalisation^1,2.  

9.     DRCS has already embarked on the Biomarker and Cognitive Impairment Study (BioCIS), to investigate the disease mechanisms and processes of dementia in Asia. Through this five-year study, the Centre seeks to better understand the neurological functioning of individuals across the disease spectrum, from the earliest stages of dementia, to those with mild cognitive impairment (MCI) but are at greater risk and those who have developed dementia. 

10.     Study participants will go through a comprehensive cognitive assessment which includes an MRI scan of the brain, blood biomarkers and cognitive evaluation by psychologists. Data collected will be analysed to detect early changes and determine whether a person is at risk of developing dementia. The findings of this study will help to inform future efforts for the early detection, prediction, and treatment of this condition. Through studies such as the BioCIS, the centre aims to develop and validate novel biomarkers and new interventions for dementia in the Asian population. The need for collaboration in the fight against dementia 

11.     Just as it is true in clinical practice and in policymaking, collaboration is key to the success in research. It is heartening to hear that DRCS has established collaborations with various healthcare partners, including the Institute of Mental Health, Khoo Teck Puat Hospital, National University Hospital and primary care providers. These partners will actively refer patients and subjects with MCI to the Centre for in-depth cognitive, neuroimaging and biomarker profiling.  

12.     I hope that more healthcare institutions and primary care providers will partner DRCS in their mission to drive translational research on dementia. It is only through the synergistic efforts of the research and healthcare communities that we can achieve greater insights and work towards better healthcare outcomes for our patients and our population. Closing 

13.     I am confident that this new Centre will strengthen LKCMedicine’s efforts to drive transformative research with a national and global impact. Along with other research centres hosted at LKCMedicine, I am sure DRCS will make great strides in contributing to the future of medicine and healthcare through disruptive discoveries. I look forward to seeing your achievements and I wish you all the best. 

14.     Thank you.

[1] Dubois B, Padovani A, Scheltens P, Rossi A, Dell’Agnello G. Timely Diagnosis for Alzheimer’s Disease: A Literature Review on Benefits and Challenges. J Alzheimers Dis. 2016;49(3):617-631. Doi:10.3233/JAD-150692

[2] Hwang A, Boes A, Nyffeler T, Schuepfer G. Validity of screening instruments for the detection of dementia and mild cognitive impairments in hospital inpatients: A systematic review of diagnostic accuracy studies. PLoS One. 2019;14(7):e0219569. Doi:10.1371/journal.pone.0219569