New community programme launched to prevent or delay dementia in stroke patients

A man with dementia at a nursing home in 2011. Around 82,000 people here have dementia, and this number is estimated to grow to 100,000 by 2030.

SINGAPORE - A programme which aims to prevent or delay the onset of dementia in stroke patients has been extended to the community after it improved patients' memory and ability to perform daily activities.

The announcement coincided with the National Neuroscience Institute (NNI) releasing findings which showed that vascular diseases, such as high blood pressure and diabetes, increased the risk of mild cognitive impairment and dementia in Asians.

Singapore has one of the world's highest rates of stroke, with more than 7,000 new patients a year. Around 82,000 people have dementia, and this number is estimated to grow to 100,000 by 2030.

Senior Minister of State for Health Amy Khor, who launched the programme on Thursday (Aug 29), stressed the importance of raising awareness of dementia and increasing support for people with the condition and their caregivers.

She noted that the Temasek Foundation-NNI Stroke Memory Rehabilitation (SMaRT) Programme, piloted in 2017 at NNI, has benefited close to 200 patients, of whom nearly 60 per cent reported a major improvement in planning abilities and doing activities of daily living without requiring any assistance.

These benefits continued three and six months after participants completed the programme.

People who suffer mild strokes have a higher incidence of getting dementia, so the programme was developed to reduce their chances of doing so by improving their cognition and daily function.

"We always focus on the physical limitations (of stroke patients) - whether they can walk, whether they can talk properly," said Associate Professor Nagaendran Kandiah, a senior consultant in Neurology at NNI.

"But we have looked at the cognitive aspects and find that patients can't function well."

Intervention to prevent dementia is usually done within the first year of the patient getting the stroke, and it works best if they are still able to walk, he added.

The encouraging results led to NNI working with five senior care centres - including St Luke's ElderCare and AWWA - to offer the eight-week programme to 1,000 participants over the next year.

Participant Celine Kuppusamy, 56, credits the programme for improving her memory after she suffered a stroke in January this year.

"When I went back to work, I forgot certain people's names, how to get to my workplace, and to take showers; I felt very frustrated," said Ms Kuppusamy, who works as a training officer at the Movement for the Intellectually Disabled of Singapore (Minds).

But the programme helped her to regain her memory through cognitive and physical exercises, and she continues to practise some of them.

Temasek Foundation has committed $1.21 million to support the SMaRT programme over three years from 2017.

Dr Khor was speaking at the 13th International Congress of the Asian Society Against Dementia and the 6th Singapore International Neuro-Cognitive Symposium at the Shangri-La Hotel.

The three-day Congress is a global forum promoting the advancement of scientific knowledge, research and clinical practice in the management of dementia, and more than 600 clinicians and medical staff from nearly 20 countries are attending.

In the light of its findings on mild cognitive impairment and dementia in Asians, the NNI has also developed a six-month training programme for primary care practitioners to help detect and treat dementia by addressing vascular risk factors like high blood pressure, diabetes and high cholesterol.

A total of 54 healthcare professionals, comprising 38 primary care physicians from the polyclinics and 16 allied health professionals, including nurses, psychologists and case managers, will attend the first course, which starts next month and ends in January next year.

High blood pressure affects the brain's ability to remove dementia-causing proteins called amyloids, while diabetes and high cholesterol produce insulin resistance, which causes the brain cells in certain areas like the memory centre to become abnormal.

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