• A new programme has been launched to help stroke patients slow or prevent the onset of dementia.
• The programme aims to improve aspects of cognition, such as memory, executive function and functional status.
• There are plans to roll out the programme in the community over the next three years.

Singapore, 17 March 2017 – Stroke patients can expect more help to make a better recovery with the launch of a new programme to slow or prevent the onset of dementia, an illness that causes mental abilities to deteriorate. The cognitive rehabilitation programme, developed by the National Neuroscience Institute (NNI), is believed to be the first such structured programme in Singapore. It is tailored to the needs of each patient to improve aspects of cognition such as memory and executive function.

There are plans to bring the NNI Stroke Memory Rehabilitation Programme (SMaRT) into the community over the next three years. To do so, NNI will be working closely with Community Care providers, with support from the Agency for Integrated Care. When fully implemented, this is expected to benefit around 2,500 stroke patients each year.

The programme caters to stroke patients with minimal physical impairments but with significant cognitive impairments. They will go through six weekly sessions, which include knowledge-sharing and hands-on activities, within the first year of suffering a stroke. The sessions cover commonly affected aspects such as memory and executive function – the ability to plan and carry out tasks. For some sessions, participants can opt to work on specific cognitive functions (e.g. language difficulty), depending on their condition.

Stroke: A Significant Cause of Disability

Stroke is a significant cause of death and disability in Singapore. It occurs when part of the brain gets damaged because the blood supply is interrupted. Around 7,000 Singapore residents were admitted to public hospitals for stroke in 2014 . As a major centre for stroke care in Singapore, NNI conducts extensive research in this area. NNI studies have shown that within six months of suffering a stroke, 36.7 per cent of patients develop cognitive impairment, including dementia. A year after stroke, the prevalence goes up to 51.5 per cent.

Associate Professor Nagaendran Kandiah, Senior Consultant at the National Neuroscience Institute said: “Current rehabilitation programmes focus on physical and functional rehabilitation but not cognition. While cognitive decline may continue after stroke, a significant number of patients will show stabilisation and improvement when provided with suitable intervention programmes. We hope they can retain their independence and enjoy a better quality of life. Without appropriate rehabilitation, patients may not be able to continue working or socialise and manage daily activities.”

For a start, the programme is now being run at the National Neuroscience Institute by its team of healthcare professionals, including nurses and psychologists. The team will also provide training to Community Care professionals. These professionals can then conduct the cognitive rehabilitation sessions in their care facilities, benefitting more stroke patients who are receiving home or day care services in the community. It will also help these patients lower their risk of dementia and better support them in ageing well at home.

“The rapidly ageing population in Singapore will contribute to a significant rise of neurological diseases such as stroke and dementia. Treatment strategies for these chronic diseases must extend to the homes and communities to maximise function, delay progression and improve quality of life. As the national centre of excellence for neuroscience care, we hope to partner with community healthcare providers to equip them with the necessary skills to meet the challenges ahead,” said Associate Professor Ng Wai Hoe, Medical Director, National Neuroscience Institute.

The programme was announced at the opening ceremony of the 5th Singapore International Neurocognitive Symposium by the Guest of Honour, Senior Minister of State for Health Dr Amy Khor. The biennial symposium, organised by NNI, is a scientific and educational meeting for healthcare professionals and partner institutions to explore collaborations in dementia care and research. Around 300 professionals, including doctors, nurses and researchers from the region, are expected to attend.