LCQ13: Measures to support dementia patients
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Question:
It has been reported that as Hong Kong's population ages, the number of dementia patients is expected to continue to rise. In this connection, will the Government inform this Council:
(1) whether it knows the respective numbers of newly diagnosed and follow-up dementia patients in the Hospital Authority (HA) in each of the past five years, broken down by age, gender and the hospital cluster concerned; whether the authorities will formulate a support plan specifically for patients with early-onset dementia;
(2) given that The Hong Kong University of Science and Technology (HKUST) has developed a highly accurate blood test for detecting Alzheimer's disease in 2024, whether the authorities will consider collaborating with the HKUST to pilot an Alzheimer's disease screening programme in the Elderly Health Centres under the Department of Health or the District Health Centres, or incorporating the relevant screening into the Chronic Disease Co-Care Scheme; if not, what measures the authorities will introduce to avoid delaying the golden hour for such patients to receive non-drug intervention treatment (eg cognitive training);
(3) whether it knows the respective median waiting time and the longest waiting time for dementia patients in each hospital cluster to be referred from general outpatient clinics to the relevant specialist outpatient clinics (eg memory clinics, psychogeriatric, neurology or geriatric departments under the HA) for diagnostic assessment, broken down by hospital cluster; whether the authorities have any plans to increase the number of professional healthcare personnel of various types to provide more services targeted at dementia patients, and strengthen training to ensure that all healthcare personnel (particularly doctors at the primary healthcare level) have the ability to identify dementia patients;
(4) whether the authorities have any plans to formulate measures to reduce the unnecessary repeated hospitalisations of advanced dementia patients, and promote home death or end-of-life care services in residential care homes; if so, of the details; if not, the reasons for that;
(5) whether it knows if the HA will consider including newly developed effective drugs for dementia (including Alzheimer's disease) in the special drug category of the Drug Formulary, or providing more comprehensive drug subsidies through the HA's safety net to reduce the burden on such patients;
(6) given that the community geriatric assessment teams and the psychogeriatric outreach teams under the HA provide outreach services to elderly persons with dementia residing in residential care homes for the elderly (RCHEs), of the current coverage rate of these services and the number of private RCHEs not covered by the above outreach services; the average service capacity allocated to the private RCHEs covered by the above outreach services each year; and
(7) given that the Government commissioned The Chinese University of Hong Kong to conduct a mental health survey for persons aged 60 or above, which was completed at the end of 2023, of the incidence rate of mental illness (including dementia) among these elderly persons; how the authorities will, based on the data from the survey and by making reference to the country's National Action Plan for Addressing Dementia in the Elderly (2024-2030), formulate a care blueprint or strategy for dementia in the next 10 years?
Reply:
President,
Dementia is a condition characterised by the deterioration of brain function due to neurological pathology. At present, there is no cure for dementia. With the help of medication and non-pharmacological interventions (such as reminiscence therapy, multisensory and cognitive training), the degenerative process of the brain can be slowed down and the symptoms can be alleviated. Except for dementia patients at a severe stage or those requiring medical care due to serious complications, patients can generally continue to live at home and access various care and support services in the community as needed, thereby maintaining their quality of life and alleviating the burden on carers. Supporting people with dementia is thus an important cross-sectoral task within the community.
In consultation with the Social Welfare Department (SWD) and the Hospital Authority (HA), the consolidated reply in response to the question raised by the Hon Grace Chan is as follows:
(1) and (3) When providing patient services at the HA's Family Medicine Clinics (formerly known as General Outpatient Clinics), doctors will provide and recommend appropriate treatment (including medication prescription and service referrals) based on the patient's clinical condition (including dementia) to meet the patient's individual needs.
Furthermore, patients with dementia commonly suffer from multiple chronic diseases, such as hypertension, diabetes mellitus and cardiovascular disease, compounded by physical decline (eg memory loss, falls, incontinence). The HA refers patients to appropriate specialist outpatient (SOP) clinics, including Internal Medicine, Geriatrics, Psychogeriatrics and Memory Clinics, according to their needs, to offer them related management as clinically indicated. For example, the geriatric team provides services to patients with dementia who also suffer from other geriatric conditions, whilst the psychogeriatric team is responsible for supporting patients with dementia who exhibit severe comorbid emotional and behavioural symptoms.
The HA has been implementing a triage system for new referrals to SOP clinics to ensure that patients with urgent conditions requiring early intervention are given priority for treatment. Under the triage system, newly referred patients (including those with early-onset dementia) are usually screened by a nurse and then examined by a specialist doctor of the relevant department, before being classified into Priority 1 (urgent), Priority 2 (semi-urgent) and Routine (stable) cases. The HA's target is to maintain the median waiting time for Priority 1 and Priority 2 cases within two weeks and eight weeks respectively, and the HA has been able to meet the target. The HA does not maintain statistics on waiting time for patients with dementia referred from Family Medicine Clinics to various SOP clinics.
The number of dementia patients receiving services in each hospital cluster under the HA with breakdown by gender and age group from 2021 to 2025 is set out at Annex.
The HA delivers healthcare services through multi-disciplinary teams comprising doctors, nurses, allied health professionals and care-related support staff. The HA closely monitors its manpower situation and introduces a series of measures to attract, train and retain talents. The HA implements ongoing measures including increasing the quotas of resident trainees to recruit local medical graduates; recruiting non-locally trained healthcare professionals to supplement local recruitment efforts; improving promotion opportunities and providing specialty allowances to retain staff; recruiting part-time healthcare staff (for example, through the recruitment of locum staff); offering flexible full-time work arrangements; offering further employment after retirement to suitable retired staff according to operational needs; enhancing the Home Loan Interest Subsidy Scheme; and establishing the HA Academy to increase training opportunities across different grades.
The HA provides dementia-related training to frontline healthcare staff to enhance their knowledge and skills in early identification, enabling them to adopt appropriate methods for patient care and communication. The HA also offers specialty nursing certificate courses and e-learning programmes for nurses, covering the nursing care of patients with dementia.
In addition, the Primary Healthcare Commission (PHC Commission) has been committed to promoting the training and professional development of primary healthcare professionals, including the provision of training on elderly health services (including cognitive health). For primary healthcare doctors, the PHC Commission collaborates with training institutions to offer continuing medical education programmes for family doctors, covering disease management for patients across different age groups. On the other hand, it also provides elderly health-related training courses for cross-disciplinary teams, covering topics such as cognitive health assessment and early intervention.
(2) Regarding elderly health services, the PHC Commission will commence phased integration of the Department of Health (DH)'s Elderly Health Centres into the district health network starting in 2026-27. The PHC Commission will adopt a new service model featuring standardised protocol-driven care pathway specifically designed for the elderly. Under this new model, the district health network will provide personalised health risk assessments and health education services to members aged 65 or above, and further enhance the accessibility through establishing additional service points and an overall increase in service capacity. The PHC Commission will also collaborate with the HA's Family Medicine Clinics and family doctors in the community to establish a more comprehensive long-term follow-up mechanism for chronic diseases among the elderly in the community, and expand the scope of health risk assessments.
The assessment scope will cover cognition, mobility, nutrition, vision and hearing, and psychological capacity, with corresponding health risk assessments and intervention services to enhance the intrinsic capacity of older adults and formulate tailor-made, convenient and comprehensive chronic disease prevention, screening and management plans for participants. At present, the PHC Commission has established preventive care standards for the early identification, assessment, and management for older adults (including dementia) through the Hong Kong Primary Healthcare Reference Framework. When primary healthcare providers suspect cognitive impairment or deterioration in an elderly person based on direct observation, patient self-report or feedback from family members/carers, they should conduct assessment of the person's cognitive function. If the screening result is positive, family doctors should carry out a comprehensive clinical evaluation to confirm the diagnosis of dementia and provide appropriate follow-up care. The advisory group under the PHC Commission is reviewing the overall strategy for the assessment and management of dementia at the primary healthcare level, including the incorporation of screening measures suitable for implementation in primary healthcare settings, to ensure the delivery of appropriate and evidence-based services to the public.
(4) Currently, both the HA and the SWD provide relevant end-of-life (EoL) care support for terminally ill patients (including those with advanced dementia) and their families.
The HA has been providing appropriate palliative care services to terminally ill patients through a comprehensive service model. Considering that some terminally ill patients wish to remain in familiar surroundings for care, the HA provides palliative care out-patient services for discharged patients in need to follow up on their conditions. To support terminally ill patients staying in the community, the HA provides palliative day care services and home care services. Palliative care teams will formulate appropriate palliative care plans based on the patient's condition and provide holistic care covering physical, psychological, social and spiritual aspects, thereby alleviating the symptoms of the illness, improving quality of life and reducing unnecessary hospitalisation.
In addition, the elderly community care and support services, as well as the Community Care Service Voucher Scheme for the Elderly funded by the SWD, provide EoL care services to elderly persons in need (including dementia patients). Multidisciplinary service teams comprising social workers, nurses, physiotherapists, and occupational therapists assess the needs of frail elderly and formulate individual care plans, including whether EoL care services are required. Furthermore, elderly centres will provide members with relevant counselling services and arrange service referrals, where appropriate.
As for patients residing in Residential Care Homes for the elderly (RCHEs), since 2015-16, the HA has progressively enhanced the services of the Community Geriatric Assessment Teams (CGATs) and collaborated with palliative care teams and RCHEs to implement the EoL Care Programme in RCHEs which supports residents with terminal illnesses. The scope of services includes advance care planning and training for staff of RCHEs, thereby improving the quality of care and ensuring continuity of care for discharged patients.
In fact, EoL care arrangements, including dying-in-place, are a matter of personal choice for patients. We have consistently provided appropriate support for terminally ill patients who choose to pass away in their place of residence. The SWD has been supporting RCHEs and residential care homes for persons with disabilities (RCHDs) in adopting various models to provide EoL care services. From September 2017 onwards, all newly established contract homes have been equipped with an EoL care room, allowing residents to face death with dignity and peace in a familiar environment. The SWD also encourages existing RCHEs and RCHDs to make flexible use of space to provide the relevant services. Regarding legislation, under the Coroners Ordinance (Cap. 504), deaths that meet specified conditions and occur at home are not required to be reported to the Coroner. To facilitate terminally ill patients residing in RCHDs and RCHEs that are not nursing homes in opting for dying-in-place arrangements, we amended the relevant provisions of the Coroners Ordinance and the Births and Deaths Registration Ordinance (Cap. 174) in June 2024 to provide that deaths complying with the statutory conditions are also exempt from the requirement of reporting to the Coroner.
We will continue to assess the demand for EoL care services and plan appropriate service models in response to factors such as population growth and demographic changes, advances in medical technology, and healthcare staffing levels, so as to meet the overall needs of society.
(5) Over the years, the HA has been committed to increasing the use of new drugs for dementia that have demonstrated clinical efficacy, with a view to improving the quality of life of patients with dementia and slowing down their functional decline. At present, a majority of new drugs for dementia have been included on the HA's Drug Formulary as General or Special drugs. Doctors will provide patients with the necessary drug treatment appropriately, based on the patient's clinical needs and in accordance with standard clinical practice guidelines. The HA will continue to keep in view the developments in new drugs for dementia and review their use through established mechanisms.
(6) As at March 31, 2025, the CGAT's services covered 692 RCHEs (accounting for approximately 86 per cent of the total in Hong Kong).
As at December 31, 2025, the HA's psychogeriatric outreach services covered 314 subsidised and private care homes across Hong Kong.
In 2025-26, as at December 31, 2025, the CGAT provided a total of 775 846 geriatric outreach service visits to elderly residents in RCHEs (including both subsidised and private care homes). In addition, the number of psychogeriatric outreach attendances in the HA was 88 314.
(7) Following a recommendation from the Advisory Committee on Mental Health (ACMH), the former Food and Health Bureau commissioned the Chinese University of Hong Kong to conduct a survey of older people aged 60 or above. The Elderly Mental Health Survey commenced in January 2019, was completed in May 2023, and the findings were published in November of the same year.
The survey, which interviewed 4 500 older adults aged 60 or above, aimed to gain an in-depth understanding of the mental health status of older adults in Hong Kong across various areas, including cognitive impairment, depression and anxiety. The results showed that among elderly living in the community and in care homes, the overall prevalence of mild neurocognitive disorders (NCD) was approximately 20.9 per cent, whilst the overall prevalence of major NCD was approximately 8.3 per cent. Furthermore, the data indicates that 8.6 per cent of the elderly respondents had been diagnosed with anxiety and depression. The survey also identified factors such as age, marital status, educational attainment and the presence of chronic physical illnesses as being associated with the risk of NCD. The study found that lifestyle is closely linked to cognitive and emotional symptoms; elderly with higher levels of physical activity or a willingness to participate in more cognitive and social activities tend to have better cognitive and mental health.
The ACMH submitted a proposal on the Stepped Care Model on Mental Health (Stepped Care Model) to the Government in end-2025, setting out the roles of mental health professionals and stakeholders, as well as their division of work in mental health services, enhancing training to raise professionals' awareness of making referrals, and establishing the referral mechanism. The first tier of the Stepped Care Model provides prevention and promotion services. The second tier provides more structured and targeted assessment and intervention services for persons in need. The third tier (specialist services) provides specialist intervention services for moderate to severe mental health cases. This model enables the provision of mental health services with different levels of intensity for the public according to their mental health needs and severity, thereby responding more effectively to the needs of society.
Elderly centres, day care centres/units and home care services subvented by the SWD provide appropriate support services for older people with dementia and their carers. They also organise regular training sessions for staff to enhance their understanding of dementia and improve their skills in handling related cases. In addition, elderly centres organise educational activities at the neighbourhood level to raise public awareness of dementia.
The DH promotes public awareness and education on dementia and provides the latest health information through various channels, including the Elderly Health Service website, the Elderly Health Information Hotline, caregiving resource packs, online videos, media interviews, the Elderly Health Newsletter and health talks. These initiatives aim to raise public awareness of the disease, promote healthy lifestyles to build cognitive reserves among older people, and provide practical tips and insights on managing the disease to family members and carers of people with dementia, thereby supporting older people to age in place. In addition, the HA organises various health promotion activities, including educational talks and the publication of leaflets, to raise community awareness of dementia.
We will draw relevant information and experience, including the findings of the aforementioned survey and the National Action Plan for Addressing Senile Dementia (2024-2030) (the Action Plan), to formulate relevant policy and enhance various measures, by referring to the Action Plan as well as principles and directions set out under the framework of Stepped Care Model, to provide elderly with dementia with appropriate cross-sectoral follow-up.
Ends/Wednesday, April 22, 2026
Issued at HKT 18:01
Issued at HKT 18:01
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