Cecilia Van Cauwenberghe from Frost & Sullivan’s TechVision Group, examines dementia as a public health issue in Hong Kong
When it comes to looking at brief statistics of dementia in Hong Kong, we know that dementia consists of progressive disease of the brain that involves a severe decline in both cognitive and intellectual functions, affecting memory, comprehension, learning capacity, the ability to calculate, language and judgment. According to the Elderly Health Service, the Department of Health and the Department of Psychiatry, the Chinese University of Hong Kong, the prevalence of dementia is estimated to be at 5%-8% among persons aged over 65, and at 20%-30% among those aged over 80, with 15.3% for female and 8.9% for male. Yu (2012) estimated that among persons aged 60 and above, around 333 000 or 11% would be suffering from dementia in 2039.
Action plan from government
During the past decades, increasing prevalence of dementia has become a public health issue in China. A recent study was conducted by Lam et al., (2019) with the purpose to achieve a deeper understanding of the perception of Chinese in Hong Kong towards the diagnosis, symptoms and impacts of dementia. According to the study, which included a cross-sectional survey performed among 290 outpatients attending a regional public hospital, most patients preferred to be told about the diagnosis of dementia as early as possible to access proper treatment and support.
As a neurodegenerative disorder that typically occurs in elderly people, dementia is characterised by cognitive impairment and behavioural and psychological symptoms, including agitation, apathy, and personality changes. Chien et al (2019) analysed a study using the 28-item Dementia Management Strategies Scale (DMSS). The authors identified three major types of caregiving strategies in dementia care: criticism, encouragement and active management, all of them correlated with the caregiving burden and intention of institutionalising their relatives. According to the researchers, substantial modifications of dementia management strategies are demanded in China to help families to become competent in caregiving and therapeutic homecare environment. In the opinion of the authors, the DMSS, the Chinese version DMSS, covers a wide range of adaptive and non-adaptive strategies in dementia care and is useful for healthcare professionals to assess and identify family caregivers who are lack of appropriate and effective strategies.
Multisensory therapies and cognitive stimulation activities
Among the early treatments of dementia, Cheung et al (2019) investigated the feasibility and the preliminary efficacy of a cognitive stimulating play intervention on cognitive functions. The study involved 30 elderly people with early to moderate dementia recruited from two different day-care centres, which were randomised into intervention and control groups. The results exhibited that early intervention in cases of dementia is not only feasible but also recommended.
Multisensory therapies consist of the exposure of patients living with dementia to different stimuli in daily life aiming to improve their mood and alleviate their hyperactive behaviour. Combined with additional cognitive stimulation activities, multisensory therapies can also retain their abilities to receive, analyse and respond to stimulation, being more connected with the environment. In the opinion of the researchers, the fundamental role of these therapies relies on developing activities that match with the patient’s abilities and interests that focus on training their memory and attention, as well as, strengthening their abilities for spatial recognition and calculation.
Although Hong Kong has not implemented any dementia care strategy specifically for the planning and provision of support services for persons with dementia, the government has conducted reviews on the medical and long-term care services for persons with dementia through the Review Committee on Mental Health and elaborated the Elderly Services Programme Plan. As a subsequent action, a series of initiatives were announced in the Hong Kong Policy Agenda 2017 to strengthen care and support services for people living with dementia and their families at the community level. A step forward, in 2018, the Social Welfare Department (SWD) launched the “Dementia Friendly Community Campaign”, a three-year public education programme which aims at raising public awareness and understanding of dementia.
I would like to thank all contributors from the industry involved with the development and delivery of this article from Frost & Sullivan.
Cheung, D.S.K., Li, B., Lai, D.W.L., Leung, A.Y.M., Yu, C.T.K. and Tsang, K.T., 2019. Cognitive Stimulating Play Intervention for Dementia: A Feasibility Randomized Controlled Trial. American Journal of Alzheimer’s Disease & Other Dementias®, 34(1), pp.63-71.
Chien, W.T., Chan, S.W.C., Gray, R. and Yip, L.K., 2019. Psychometric properties of Chinese version of Dementia Management Strategies Scale among family caregivers. Hong Kong Med J, 25(1 Supplement 3).
Lam, T., Sun, K., Chan, H., Lau, C., Lam, K. and Sanson-Fisher, R., 2019. Perceptions of Chinese Towards Dementia in Hong Kong—Diagnosis, Symptoms and Impacts. International journal of environmental research and public health, 16(1), p.128.
Yu, R. 2012 Trends in Prevalence and Mortality of Dementia in Elderly Hong Kong Population: Projections, Disease Burden, and Implications for Long-Term Care. International Journal of Alzheimer’s Disease, vol. 2012, pp. 1-6.