2023-03 (Issue No. 38)

After three years of epidemic, the Hong Kong government has lifted most precautionary measures and requirements. Social and economic activities are gradually resuming and lives of citizens are returning to normal. Families go out to shop and “yum cha”. Streets are once again packed with people. The city is regaining its vibrancy!

Mild cognitive impairment (MCI) is a condition in which people have more memory or thinking problems than other people their age. MCI is not considered a “disease”, but more accurately described as a “high-risk condition”. Dementia may take more than ten to twenty years to manifest obvious symptoms and be diagnosed. Before that, the brain begins to degenerate, but the daily life functions are not greatly affected. People may just have declining memory and organisational skills, but they can still take care of themselves.

People with MCI are at a greater risk of developing Alzheimer’s disease or a related dementia. Estimates vary as to how many people who have MCI will develop dementia. Roughly one to two out of 10 people aged 65 or older with MCI are estimated to develop dementia over a one-year period. However, in many cases, the symptoms of MCI stay the same or even improve.

In a report published in 2022, it is noted that worldwide prevalence of MCI among community dwellers aged 50 years and older is 15.56% ⁽¹⁾. However, a recent survey in Hong Kong finds a even higher prevalence of MCI in those aged 60 years and older at 26.84% or over 540,000 in number ⁽²⁾.

According to the Mayo Alzheimer’s Disease Research Centre, conversion rate of MCI to dementia is around 10-15% per year (compared to 1-2% in the normal elderly population). Conversion rate to Alzheimer’s disease is higher and up to 80% in 6 years. In Hong Kong, 15.9% of subjects with MCI had developed dementia at the end of a 2-year follow up ⁽³⁾.

Dementia is a heavy burden on patients, families, carers and society. Prevention and early intervention are therefore of utmost importance. But most currently available services are mainly centred on Care and Support, and targeted towards those already affected. There is a need to implement a systematic intervention strategy after MCI is diagnosed to try to delay the onset of Dementia or even alter the rate of MCI conversion to Dementia.

To address this gap, the Foundation is developing a programme to screen at-risk groups and provide intervention to those diagnosed with MCI. Details of the programme will be announced in due course. Please stay tuned!

References:
(1) https://academic.oup.com/ageing/article-abstract/51/8/afac173/6670563
(2) Interim analysis of Hong Kong Mental Morbidity Survey for Older People (MMSOP) 2021
(3) The Hong Kong Medical Journal 2018 

Representatives of the Foundation visited the Christian Family Service Centre Mind Delight Memory and Cognitive Training Centre in Kowloon Bay on 20 March. The Foundation has been working in collaboration with the Centre to provide service and support to people with dementia and their carers as well as training to dementia care professionals and volunteers.