• High blood pressure and diabetes increase risk of dementia; essential to manage these factors to prevent dementia
  • Launch of community phase for the Temasek Foundation–NNI Stroke Memory Rehabilitation (SMaRT) Programme, expansion of the pilot structured cognitive rehabilitation initiative for post-stroke patients to reduce rate of cognitive decline
  • Dr Amy Khor, Senior Minister of State, Ministry of the Environment and Water Resources & Ministry of Health is the Guest-of-Honour for the 13th International Congress of the Asian Society Against Dementia (ASAD) and 6th Singapore International Neuro-Cognitive Symposium
Singapore, 29 August 2019 – Dementia is one of the top four neurological conditions in Singapore, affecting close to 82,000 patients. An additional 150,000 persons is estimated to have pre-dementia and will develop dementia over the coming years. The National Neuroscience Institute (NNI) and Temasek Foundation are launching the community phase of the Temasek Foundation–NNI Stroke Memory Rehabilitation (SMaRT) Programme to support new stroke patients at risk of dementia. NNI will also work with primary care networks on a new pilot community programme for the prevention and diagnosis of early dementia.

With an ageing population, it is estimated that there will be more than 100,000 persons with dementia by 2030. Neurological diseases such as dementia and stroke currently account for 6.6%1 of the national disease burden in Singapore with long-term debilitating symptoms that affect brain function and day-to-day activities.

Into the Community: Cognitive Rehabilitation for Stroke Patients

Stroke is a major cause of impaired memory and thinking. Findings2 from NNI showed that 37.3% of patients with strokes go on to develop post-stroke cognitive impairment (PSCI) within six months after suffering a stroke. If PSCI is not managed, patients are twice as likely to develop dementia. With post-stroke patients at a higher risk of suffering from vascular dementia, it is essential to increase preventive measures for early intervention.

The SMaRT Programme aims to improve problem-solving, long-term memory, information-processing speed, mental flexibility, language, navigation skills and attention to enhance the quality of life.

“Singapore has one of the world’s highest rates of stroke, with more than 7,000 new stroke patients a year. Patients with mild strokes have a higher incidence of getting dementia. The Temasek Foundation–NNI SMaRT Programme was developed specifically to reduce this incidence rate by providing a continuum of cognitive rehabilitation care, in the community and at home, for the stroke patient after the hospital discharge. The early outcomes of this pilot have been positive, with the patients who participated in the cognitive rehabilitation having stable function in their daily routines and overall improvement of their quality of life,” said Mr Richard Magnus, Chairman, Temasek Foundation Cares.

More than 200 persons have benefitted from the programme since the pilot started. Results of the eight-week programme showed that the patients had improved memory, planning ability, activities of daily living and overall quality of life. Patients were able to regain independence to cope with daily tasks like meal planning and taking public transport. There is also improvement in mood symptoms. The findings also showed that the benefits of the 8-week programme continue at three and six months after completion of the programme. 

In the next phase, NNI will partner senior care organisations to introduce the SMaRT Programme to the community which is expected to benefit 1,000 persons. These organisations will be taught the principles of cognitive rehabilitation as well as how to deliver and evaluate the effectiveness of the SMaRT programme through 72 hours of training over 12 weeks.

“Introducing the SMaRT Programme in the community increases access for post-stroke patients and their families to prevent dementia. Through such collaborations with our community partners in the fight against dementia, we aim to equip more healthcare professionals with the knowledge to manage vascular dementia and enhance the quality of life for patients and caregivers,” shared A/Prof Nagaendran Kandiah, Senior Consultant, Neurology, NNI.

Manage Vascular Risk Factors - Prevent Dementia
NNI Comprehensive Course in Dementia and Cognitive Impairment

Beyond treatment, it is essential to prevent the onset of dementia. Findings from NNI have demonstrated that vascular diseases such as high blood pressure and diabetes increase the risk of Mild Cognitive Impairment (MCI) and dementia in Asians. High blood pressure, for example, affects the brain’s ability to remove dementia-causing proteins called amyloid.

To prevent or delay the onset of dementia, adopting preventive approaches are essential to halt the disease. NNI has led the development of a new 6-month training programme for primary care practitioners to help detect and treat dementia by addressing vascular risk factors. The training programme will provide case-based training to enable primary care practitioners to acquire skills for diagnosis of early stage dementia. Practical measures to control vascular risk factors such as hypertension among patients with dementia will also be emphasised.

A/Prof Nagaendran elaborates, “It is critical to manage vascular risk factors such as diabetes and high blood pressure to prevent or delay dementia. Partnering primary care will ensure long-term monitoring of vascular risk factors for persons at risk of dementia and early intervention can lead to better care outcomes for patients.”

“As the National Specialty Centre for neurological diseases, NNI is tasked to lead the battle against dementia and neurological diseases. For us to win the war however, we need the support of partners throughout the care continuum to improve neuroscience care in the community for the nation.” said A/Prof Ng Wai Hoe, Medical Director, NNI.

“Family Physicians play an important role to identify and manage vascular risk factors that predispose patients to dementia. This programme allows our doctors to be equipped with the necessary skills to play a bigger role in the prevention, early identification and management of dementia. Our goal is to keep these patients healthy and able within the community, and to improve the quality of life for them and their caregivers,” shared Dr Farah Safdar Husain, Family Physician, SingHealth Polyclinics – Marine Parade.

13th International Congress of the Asian Society Against Dementia (ASAD) and 6th Singapore International Neuro-Cognitive Symposium

The 13th International Congress of the Asian Society Against Dementia (ASAD) and 6th Singapore International Neuro-Cognitive Symposium from 28 to 31 August, is an international congress hosted by Singapore. Themed “Early Diagnosis and Timely Intervention of Neurocognitive Disorders”, the sessions cover biomarkers for pre-dementia, young onset dementia (YOD), clinical aspects of dementia, prevention through the management of vascular risk factors and treatment. Over 600 clinicians and medical staff from close to 20 countries will be attending this three-day programme. The opening ceremony on 29 August will see the launch of the Community Phase of the SMART programme by Senior Minister of State, Dr Amy Khor, Ministry of the Environment and Water Resources & Ministry of Health.