Dementia in Singapore: Understanding the Shifting Landscape

Recent data from the Institute of Mental Health (IMH) and parliamentary reports provide a detailed look at how dementia is affecting Singapore’s rapidly ageing population. While some trends offer hope, the absolute numbers suggest a significant challenge ahead for the healthcare sector and families alike.

A Positive Shift in Prevalence

According to the second Well-being of the Singapore Elderly (Wise) study, the prevalence of dementia among adults aged 60 and above has dropped to 8.8 per cent (approximately one in 11 people), down from 10 per cent a decade ago. Researchers attribute this decline to several key factors:

• Higher Education and Employment: There has been a notable increase in the number of older adults who are employed and have attained higher education compared to 2013.

• Improved Health Management: A decrease in the prevalence of stroke, a major risk factor for dementia, has also contributed to this downward trend.

• Active Ageing Initiatives: Government efforts to promote active ageing and the early treatment of chronic conditions have helped "bend the curve".

The Challenge of a "Super-Aged" Society

Despite the drop in percentage, the actual number of people living with dementia is rising due to Singapore's ageing population. The number of older adults with the condition grew from 51,934 in 2013 to approximately 74,000 in 2023.

As Singapore becomes a "super-aged" society, this figure is projected to more than double, reaching an estimated 152,000 by 2030. On a global scale, it is estimated that someone develops dementia every three seconds.

Closing the Diagnosis Gap

One encouraging finding is the improvement in detection. In 2013, roughly 70.6 per cent of seniors meeting dementia criteria were undiagnosed; by 2023, this figure dropped to 51.5 per cent. This improvement is linked to better awareness and increased diagnostic services in hospitals and the community.

To meet this growing need, the Ministry of Health has ramped up capacity, increasing dementia daycare places from 3,700 in 2019 to 4,700 in 2023. Furthermore, dementia services are now available at 16 polyclinics across the island.

Who is Most at Risk?

The Wise study identified specific groups that face a higher risk of developing the condition:

• Age: Those above 85 are 11 times more likely to have dementia than those in the 60 to 74 age group.

• Employment Status: Retirees and housewives were 11 times and nine times more likely, respectively, to have the condition compared to those who remained employed.

• Medical History: Individuals with a history of stroke are 6.5 times more likely to have dementia, while those with depression face nearly three times the risk.

The Caregiver's Burden

Dementia remains the largest contributor to disability and care needs among older adults in Singapore. The study highlighted that 88 per cent of those with dementia require care, and their caregivers face a significantly higher burden (37 per cent) compared to those caring for individuals without the condition (18 per cent). These findings underscore the vital importance of not just medical treatment, but also psychosocial interventions and support for caregivers to prevent burnout and mental health struggles.