Speech by Dr Amy Khor, Senior Minister of State for Health at the Opening Ceremony of the 5th Singapore International Neurocognitive Symposium, 17 March

Associate Professor Ng Wai Hoe,

Medical Director of the National Neuroscience Institute,

Associate Professor Nagaendran Kandiah,

Chairman of the Organising Committee,

Members of the Organising Committee, Faculty, and Guests

INTRODUCTION

1. A very good morning to you. It is my pleasure to join you for the opening ceremony of the 5th Singapore International Neurocognitive Symposium. I would like to extend a warm welcome to all participants, especially our overseas delegates, as we explore collaborations in dementia clinical care and research.

PREVALENCE OF DEMENTIA

2. In Singapore, one in 10 people aged 60 and above has dementia1. The impact on sufferers can be debilitating, as the condition leads to a decline of mental abilities, including memory and judgement. We expect to see an increasing number of seniors with dementia as our population ages. So it is important to prepare our facilities, services and community to support seniors who may experience the onset of dementia in the coming years.

3. We are expanding the range of care options available in the community. Currently, there are around 1,000 dementia day care places. By 2020, we will add another 2,000 places. We are also upgrading our nursing homes and community hospitals to be more dementia-friendly. To involve the wider community, we will set up more Dementia Friendly Communities (DFCs), where residents, businesses and other partners are trained to identify and assist seniors with dementia.

1 Source: Well-being of the Singapore Elderly (WiSE) study by the Institute of Mental Health

EARLY INTERVENTION FOR A BETTER TOMORROW

4. While we work to provide necessary care for patients with dementia, it is equally important to increase public awareness of dementia and how to lower the risk of developing it. Hence, it is apt that the theme for this year’s conference is “Early Intervention for a Better Tomorrow”. Early intervention is key to prevent or delay the onset of dementia. The Government has rolled out various initiatives to help individuals recognise the warning signs of dementia, encourage them to minimise the risks of dementia through regular exercise, staying cognitively active and socially engaged, and recognising the importance of good nutrition. In this regard, the Health Promotion Board has run several dementia public education campaigns which include skits and talks on dementia in the community. Targeted at seniors and caregivers, the campaigns have been well received. Participants who attended the talks shared that they are better able to recognise the warning signs of dementia and had benefitted from the practical tips to intervene early. The Agency for Integrated Care or AIC has also produced several resource kits such as the “Knowing Dementia” toolkit to help with recognising the signs and lowering the risk of developing dementia. The toolkit also provides a suggested list of interesting activities that caregivers can do with their loved ones with dementia.

HIGHER RISK OF DEMENTIA FOR STROKE PATIENTS

5. Many may not know that stroke patients are at higher risk of dementia. As such, public awareness of the signs of stroke is also key to facilitating timely treatment and optimising treatment outcomes. A significant number of dementia cases here are caused by silent strokes, where there are no overt physical symptoms. A silent stroke occurs deep in the brain when a blood vessel is clogged, cutting off blood supply and damaging brain cells there. Such patients may suffer cognitive impairment that range from deteriorating memory and thought processes, to dementia. It is critical that we diagnose memory loss and cognitive impairment early in stroke. The Health Promotion Board’s “You Can Spot a Stroke” campaign in Oct 2016 sought to help individuals better recognise the signs of stroke and act fast to seek medical help, through a mnemonic F.A.S.T (Face, Arms, Speech, Time), which has been used internationally.

6. The work of the National Neuroscience Institute, as a major centre for stroke care in Singapore, is important in understanding the link between stroke and dementia. NNI’s research on post-stroke dementia has identified risk factors such as age, level of education and extent of damage to the brain. This will be crucial in identifying stroke patients who are at risk of dementia so timely intervention may be initiated. Many of the risk factors can be identified within a few days following the stroke, so patients can take action to prevent cognitive impairment and retain their independence.

7. In this regard, I am heartened to learn that NNI is developing a structured cognitive rehabilitation programme for suitable patients. Patients will go through knowledge sharing sessions and hands-on activities to improve aspects of cognition, such as memory and attention. The programme will cater for patients within the first year after stroke, to help them transit back to the community and their workplaces.

8. NNI will be working with AIC to bring this programme to more centres in the community through capability building of community professionals from voluntary welfare organisations. In this manner, community care providers can keep abreast of developments and be prepared to better manage dementia. I hope to see our community partners pro-actively coming on board to support this initiative.

CONCLUSION

9. With increasing numbers of seniors with dementia in Singapore, a coordinated and concerted effort needs to be taken by government, related agencies, and the community to support patients and caregivers. By building capabilities and strengthening our partnerships, we can better manage dementia in Singapore. I hope that this symposium will bring about more partnerships. I wish all of you a fruitful and enriching time ahead. Thank you.