dementia in the digital era
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Cecilia Van Cauwenberghe from Frost & Sullivan’s TechVision Group shines the spotlight on dementia in the digital era, from a Hong Kong perspective

Dementia as a condition belongs to a group of settings characterised by the impairment of at least two brain functions. The most frequent are memory loss and judgement; however, symptoms may vary from forgetfulness, limited social skills and thinking abilities. As a result, daily working activities are altered. The prevalence of dementia in the Asia region, including Hong Kong, is rising sustainably. As a consequence, the demand for community care services is experiencing a critical increment. According to medical researchers, the competence of dementia care staff working in community care settings is fundamental to achieve the expected quality of care (Chan et al., 2020). Similarly, the effects of digital solutions to anticipate challenges in dementia care as well as the best-suited training for their use in care practices play a fundamental role.

Digital health systems helping to address dementia

Prevention at the individual level is vital to address these escalating challenges. Increasing access to digital health systems and transitioning away from primarily in-person visits to a virtual care model are the most logical ways to tackle dementia-related conditions.

Healthcare systems are increasingly employing digital tools for health coaching. Beyond early diagnostics, health coaching has demonstrated significant positive results during the past two years by increasing health-promotion behaviours that impact both the development and progression of chronic health conditions such as dementia. Digital health coaching constitutes an innovative approach to reducing the hindrances associated with cost and accessibility to additional forms of preventive care.

Some words about the Asian digital health market

Increasing interest in the digital health space has been evident for the past two decades in the Hong Kong region. The digital healthcare market in Asia is poised to accelerate as progress in value-based reimbursement models advance the ability to support the current focus on chronic conditions, post-acute care and long-term care management (Bu, 2019). With healthcare systems worldwide moving toward value-based care and embracing emerging concepts such as population health management, care coordination and patient engagement, digital healthcare tools, including health coaching, will play a vibrant role in data-driven environments that support value-based reimbursement models.

The advancement in artificial intelligence (AI) and extended reality has served to further the interest of companies looking to get involved in the digital health market. Frost & Sullivan believes that the digital health market will continue to grow at robust rates, from an estimated global total of $147 billion in 2019 to more than $220 billion in 2023 (Bu, 2019). Digital health solutions offer great promise for new care delivery models, expanded access, plus improved outcomes and efficiency. Stakeholders are realising their value facing challenges that are common to all areas of the world: an ageing population, rising prevalence of chronic diseases, anticipated medical staff shortages, long wait times, quality-of-care concerns, and the need for a common technology platform. Those companies providing virtual care models based on a personalised approach to medicine are gaining significant attention with a distinct competitive edge.

Health coaching as a standard therapy

Virtual care platforms provide health coaching from experienced healthcare providers and medical institutions. Individuals are supported by evidence-based programmes that address their behaviours and underlying health conditions to facilitate them and deal with the further triggers of potential chronic conditions (Volpe et al., 2020). The level of engagement between individuals and experts is crucial to guarantee an honest, a functional and preemptive behavioural solution.

A systematic review and meta-analysis was recently published (Cheng et al., 2020), where the effects of 131 randomised controlled trials, published between 2006 and mid-2018, for dementia caregivers with community-dwelling care-recipients were compared. According to the findings, the introduction of educational programmes with psychotherapeutic components, counselling, and mindfulness-based interventions had the strongest impacts on reducing depressive symptoms associated with dementia. Although some studies were from North America and Europe, there was a growing number from Asia and other parts of the world, which support the rising demand for coaching, digitally guided, advisory interventions. Recommendations from the study also highlight the flexibility of the interventions and, most importantly, the individual customisation of each treatment. According to other various researchers, digital systems also provide information that enables to evaluate the effect of cognitive training interventions in the reduction of depression rating scale score in people with cognitive impairment (Chan et al., 2020).

Final remarks

The integration of individual expert medical care with digital tools and remote patient monitoring allows providing patients with dementia a way to address lifelong behavioural changes with improved health results. Hong Kong is well-positioned to embrace these systems due to its easy access to and early adoption of communication technologies. These systems also involve significant cost savings. Beyond providing virtual care mobile apps without human assistance — successful results come from community care services which are highly individualised and differentiated holding digital therapeutic programmes — combined with real human health coaching and therapy throughout the entire development and progression of the condition.

 

Acknowledgements

I would like to thank all contributors from industry involved with the development and delivery of this article from Frost & Sullivan.

 

References

  1. Bu, J. 2019. Growth Opportunities in the US Remote Patient Monitoring Market Forecast to 2023. Frost & Sullivan Marketing Engineering Research.
  2. Bu, J. 2019. Global Digital Health Outlook 2020. Frost & Sullivan Marketing Engineering Research.
  3. Chan, J.Y., Chan, T.K., Kwok, T.C., Wong, S., Lee, A.T. and Tsoi, K.K., 2020. Cognitive training interventions and depression in mild cognitive impairment and dementia: a systematic review and meta-analysis of randomized controlled trials. Age and Ageing.
  4. Chan, H.Y., Ho, F.K., Chui, K.C., Hui, E.Y., Wong, B., Chong, Y.Y., Bowes, A. and Kwok, T.C., 2020. Capacity building for dementia care in community care services: a mixed methods approach. BMC geriatrics, 20, pp.1-10.
  5. Cheng, S.T., Li, K.K., Losada, A., Zhang, F., Au, A., Thompson, L.W. and Gallagher-Thompson, D., 2020. The effectiveness of nonpharmacological interventions for informal dementia caregivers: An updated systematic review and meta-analysis. Psychology and Aging, 35(1), p.55.
  6. Volpe, U., Amin, H., Ayinde, O.O., Burns, A., Chan, W.C., David, R., Dejanovic, S.D., Djokic, G., Eraslan, D., Fischer, G.A. and Gracia‐García, P., 2020. Pathways to care for people with dementia: An international multicentre study. International Journal of Geriatric Psychiatry, 35(2), pp.163-173.

 

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