Traditional Chinese Simplified Chinese Email this article
LCQ17: Dementia

     Following is a question by the Hon Tang Ka-piu and a written reply by the Acting Secretary for Food and Health, Professor Sophia Chan, in the Legislative Council today (February 25):


     It is learnt that the number of dementia patients has increased in recent years amid an ageing population.  Following the establishment of the Review Committee on Mental Health in May 2013, the Government set up an expert group under the Committee to study the care for dementia patients.  In this connection, will the Government inform this Council:

(1) of the average waiting time for those people who received assessment for dementia, the number of patients diagnosed with the disease (with a breakdown by age of the patients and hospital cluster to which their places of residence belong), as well as the average waiting time for patients who had been diagnosed with the disease to receive the first treatment, in the past five years;

(2) of the objectives and progress of the work of the aforesaid expert group; whether the authorities will consider following the practices of the United Kingdom and Taiwan by formulating specific healthcare policies on dementia; if they will, of the details; if not, the reasons for that;

(3) whether it knows the non-self-financed drugs currently provided by the Hospital Authority (HA) for dementia patients (and set out the various categories of drugs by different degrees of symptoms suffered by the patients);

(4) whether it knows the non-pharmacological treatment services currently provided by various public hospitals for dementia patients and the relevant service quotas, and whether it has assessed the effectiveness of such services (and set out the information by hospital cluster);

(5) whether assessment for dementia is included in the Elderly Health Assessment Pilot Programme currently provided by elderly health centres; if it is included, of its effectiveness; if not, the reasons for that, and whether the authorities will consider including such an assessment in the programme;

(6) whether it will consider launching a public-private partnership programme to provide medical consultation services for dementia patients; if it will, of the details and timetable for launching the programme; if not, the reasons for that;

(7) of the efforts made by the authorities in the past five years to strengthen and integrate the healthcare and social welfare services related to dementia; as this year's Policy Address has mentioned that the authorities will invite the Community Care Fund to explore the implementation of a pilot scheme by drawing on the concept of "collaboration between the welfare and healthcare sectors", with a view to providing integrated community healthcare and rehabilitation services in suitable elderly health centres for elderly persons living in the community and suffering from dementia, of the concrete plans in this regard; and

(8) as the authorities pointed out in its progress report submitted to this Council in September last year on the motion on "Formulating a comprehensive elderly care policy to deal with population ageing" that adopting a unified Chinese equivalent to "dementia" would help promote public understanding on the disease and that "認知障礙症" would be adopted as the Chinese equivalent to dementia in all government documents, whether the authorities will consider stepping up its publicity to keep the public well informed of such a practice; if they will, of the details; if not, the reasons for that?


(1) The Hospital Authority (HA) has put in place a referral and triage system for its psychiatric specialist out-patient services to ensure that appropriate support and timely treatment are provided for patients with varying degrees of illness.  New patients are usually first triaged by nurses and reviewed by specialist doctors for classification into priority 1 (urgent), priority 2 (semi-urgent) and routine cases on the basis of their clinical conditions and presenting symptoms.  The HA's targets are to maintain the median waiting time for first appointment of priority 1 and 2 cases within two weeks and eight weeks respectively.  This is to ensure that patients with urgent healthcare needs are given medical attention within a reasonable time.  In 2013-14, there were about 11 900 patients with dementia receiving psychiatric specialist services provided by the HA, and the median waiting time for first appointment of psychogeriatric service was eight weeks.

(2) Set up in May 2013, the Review Committee on Mental Health is responsible for reviewing the existing policy on mental health with a view to mapping out the future direction for development of mental health services in Hong Kong.  Two expert groups were set up under the Review Committee.  The group tasked with studying dementia is reviewing the delivery model of existing care services, and will make recommendations on ways to enhance long-term care for dementia patients.

(3) Regarding drug treatment, special drugs for treating dementia (including Donepezil, Galantamine, Rivastigmine and Memantine) are included in the Hospital Authority Drug Formulary.  Special drugs are prescribed by specialists for patients who have been assessed as having the specified clinical conditions and the clinical therapeutic needs.  The drugs required will be provided by the HA at the standard fees and charges.  For patients who do not have the specified clinical conditions but choose to use and are prescribed the special drugs, they will have to pay for the drugs as self-financed items.  Taking the patients' wish into account, specialists will provide necessary treatments for patients according to the clinical needs of the patients and the clinical treatment protocol.

     The HA has been taking measures over the years to increase the use of new anti-dementia drugs with proven clinical efficacy to improve the quality of life and delay the functional deterioration of dementia patients.  The number of patients using new anti-dementia drugs increased from 6 800 in 2009-2010 to 13 900 in 2013-2014.  In 2014-15, the HA allocated an additional funding of $12 million to increase the use of new anti-dementia drugs to benefit more patients whose clinical conditions allow the use of these drugs.  The HA will continue to keep in view the development of new anti-dementia drugs and review the use of drugs through the established mechanism.

(4) Through its clusters the HA strives to provide in-patient, specialist out-patient, day hospital and community outreach services for patients with dementia.  If a patient is suspected to have developed dementia, he/she will be referred to the relevant specialty of a hospital for assessment.  Depending on the severity of the condition, the medical team will formulate individualised treatment plans for the patients, provide them with medication, cognitive training and rehabilitation services, and refer them to suitable social service agencies for follow-up, according to the need of the patients in each case.  The HA also provides support and training for family members and carers of patients with dementia through different channels with a view to enhancing their understanding of dementia and their caring skills.

     Elderly patients residing at residential care homes for the elderly (RCHEs) are supported by the HA's outreach services through its community geriatric assessment teams and psychogeriatric outreach teams.  The service targets cover elders with dementia.  Services provided include formulation of treatment plans, monitoring of patients' recovery and follow-up consultations.  On-site training will be given to care workers at the RCHEs, if required, to enable them to master the skills in taking care of dementia inmates.  At present, the HA's community geriatric assessment teams serve about 650 RCHEs, while the psychogeriatric outreach services cover most subvented RCHEs and over 200 private RCHEs in the territory.

     The HA has also made available information relating to dementia, care management and community resources on its one-stop Smart Patient website, with a Smart Elders webpage dedicated to strengthening support for high-risk elderly patients.

(5) The Elderly Health Centres of the Department of Health (DH) serve elderly people aged 65 or above by providing them with integrated primary healthcare services, such as health assessment, counselling, medical treatment and health education.  The services of the Elderly Health Centres include assessment and examination for dementia.  The centres adopt internationally recognised assessment tools suitable for the local elderly to examine their members for any symptoms of dementia during regular health assessment.  The Elderly Health Centres will provide follow-up services for members or refer cases for follow-up by HA specialists if necessary.  As at September 2014, Elderly Health Centres identified 1 818 suspected cases of dementia by using the assessment tools, representing about 6 per cent of the persons receiving health assessment over the same period.

(6) Before deciding whether to introduce a public-private partnership programme for a clinical service, the HA will take into account a series of factors, including service demand, service capacity of the market and service quality, and patients' clinical conditions and acceptance. Relevant stakeholders including the specialties and patients concerned will also be widely consulted.  For dementia, the HA will keep the situation in view before considering whether public-private partnership is applicable to this type of clinical service.

(7) Dementia affects the physical, psychological and cognitive domains of a patient.  For patients with dementia living in the community, they require support services in different areas and social care in the community is often more important than medical care.

     In view of this, the Administration has been promoting medical-social collaboration in providing appropriate services for persons with dementia.  On the part of the HA, medical personnel will conduct assessments and arrange social service referrals for persons with dementia and their families based on their needs.  The HA's community geriatric assessment teams and psychogeriatric outreach teams provide outreach services for RCHEs to support elders with dementia and their carers.  Besides, medical social services are available in public hospitals and some specialist out-patient clinics to provide psychological intervention for patients including persons with dementia.  The DH also collaborates with the Social Welfare Department and non-governmental organisations to organise dementia seminars, workshops and health talks to give practical tips on dementia care.  The Administration will continue to explore the adoption of medical-social collaboration in strengthening community care and rehabilitation services for persons with dementia.

(8) All along the community has different views about the equivalent of the term "dementia" in Chinese.  Chinese nomenclatures such as "腦退化症", "老年癡呆症" and "認知障礙症" have been widely used by the public to refer to “dementia”.  Taking different views into account, we consider "認知障礙症" a relatively neutral term which will promote better understanding of the disease.  The Government has taken the lead in using the term "認知障礙症" in government documents.  We will continue to encourage wider adoption of the term "認知障礙症" through education and promotion.

Ends/Wednesday, February 25, 2015
Issued at HKT 16:02


Print this page