1. Hearing loss is a common disability and related to other adverse health outcomes. We found a positive relationship between hearing loss with incident of mild cognitive impairment and dementia in community dwelling older people in Singapore. We have another study underway using more accurate hearing tests with ENT colleagues at NTFGH and also planning to study the effect of hearing aid on prevention of cognitive impairment. Use of hearing aid may potentially reduce social isolation, delay cognitive decline and maintain health of older people.
2. We found that 3% of community dwelling older people in Singapore are malnourished and 28% are at risk of malnutrition (ref 2). We also developed a nutrition prognostic index to identify older adults in primary care settings who are at increased mortality risk. This malnutrition syndrome contributes to the state of being or becoming physically frail. In the same cohort 5% were frail and 46% pre-frail. This predisposes them to adverse health outcomes (e.g. frequent hospitalisation, earlier functional disability, admission to nursing homes and death. As with others, we have found effective strategies to reverse such frailty. We are planning studies with different partners to identify these vulnerable older people for community preventive interventions.
3. Other than physical frailty, we identified social and mental frailty phenotypes in community dwelling older people. Independently and together, these put older people at increased risk of adverse health outcomes. We are working with MOH colleagues to look at the risk of increased hospitalisation and referral to nursing homes.
4. From our local research data, we developed a risk score to identify community dwelling seniors in Singapore who are at risk of developing mild cognitive impairment. With local business partners we are instituting a community based multi-domain program (exercise, cognitive training and dietary strategy) to improve cognition for seniors (MOH National Innovation Challenge Cognition Grant Project).
5. We worked with colleagues from IBN A*Star and successfully tested a smart diaper system which has been effective in reducing the amount of time nursing home residents spent in wet diapers. We are conducting a further study on a more advanced smart diaper system that can also detect faeces, trigger alert and reduce time spent in soiled diapers for people with dementia and incontinence, towards more person centred care (A*Star MedTech Grant Project).
6. With colleagues from NUS Saw Swee Hock School of Public Health, we have embarked on a project to assess the profile, physical and mental health as well as the extent of patient-centeredness of dementia care in local nursing homes. In addition, we are also working with colleagues from NUS School of Design and Environment to design future ready and sustainable nursing homes for person-centric care models in communities (URA Land and Liveability National Innovation Challenge Project).