Taking action against dementia
Published: 15 Mar 2018
Dementia is a word that describes a wide range of symptoms that are associated with declines in memory and other cognitive abilities, to the point that a person is unable to perform routine, daily activities and tasks. It is linked to ageing and also results from certain injuries or diseases such as Alzheimer’s disease, and is increasingly common in Singapore.
Currently, an estimated one in 10 people aged 60 and above has dementia, and half of those aged 85 and older have it. These numbers are expected to increase more than twofold to 103,000 by 2030.
The two main risk factors for dementia are age, with it doubling every five years after 65 years of age, and a positive family history of dementia, which is a genetic predisposition. While these two risk factors are hard to prevent altogether, there are several modifiable risk factors that may delay the progression of dementia if addressed correctly. These risk factors may include biomedical factors such as diabetes, mid-life hypertension, mid-life obesity, lifestyle factors such as smoking, excessive alcohol consumption, chronic poor sleep, and psychological factors such as depression, loneliness and social isolation.
Hearing loss has also been identified as a significant risk factor of dementia, according to a local study conducted by the National University of Singapore and Ng Teng Fong General Hospital, highlighting the need for early diagnosis and intervention.
“People think that hearing loss is a part of ageing and do not do anything about it,” commented Associate Professor Reshma Merchant, the head of the Division of Geriatric Medicine at National University Hospital and geriatric education director at NUS Medicine. But those with hearing loss may need more effort to hear degraded sounds, so fewer brain resources are available for thinking and memory. They may also be more socially isolated, putting them at further risk of dementia.
But community efforts aimed at delaying the onset of dementia have grown over the past year. The Healthy Ageing Promotion Programme For You (HAPPY) which was implemented since August 2017, is one of them.
The programme offers dual-task exercises that are aimed at improving the memory of frail elderly people and reducing their frailty and associated disability, as frailty is associated with higher risks of dementia development.
“For instance, while I am marching, I am counting 30 backwards or recounting the names of fruit or hawker food that the other people here like to eat,” said A/Prof Merchant. “These activities can be done in groups of five so this increases social interaction.”
These sessions are free, and more than 300 seniors have benefitted from participating twice a week for at least six months at various community and senior activity centres. Approximately 100 of the participants have also been recruited for longitudinal follow-ups to examine the effectiveness of the exercises, and the programme is set to expand by working with the Agency for Integrated Care to accommodate more than 1,000 seniors within the next two years, according to A/Prof Merchant.
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