Elderly care as one of the important government policy agenda

According to the latest government population projections, more than a third of the population will be aged 65 years by 2046, with the number of adults aged 65 expected to increase from 1 190 000 in 2016 to 2 510 000 in 2046. The soaring elderly population will inevitably put extra strain on our overly stretched health care system, with dementia management being one of our biggest challenges. More than 8.5% of community-dwelling older adults suffer from mild cognitive impairment (MCI) and 8.9% suffer from mild dementia, according to the latest epidemiological study of dementia in Hong Kong. 1 Dementia is not restricted to only cognitive impairment and functional decline; there is a wide range of behavioural and psychological symptoms of dementia (BPSD), including delusion, disinhibition, violence, irritability, and yelling. These symptoms are distressing not only to the patients themselves, but also to their caregivers. Moreover, the presence of BPSD is also linked to a higher mortality rate, 2 greater medical expenditure, and earlier institutionalisation. 3 Early and accurate diagnosis, prevention, and continuous integrated care are vital in across all stages of dementia management. 4 However, delayed diagnosis of dementia is often seen in Hong Kong, 5 preventing patients with BPSD from receiving beneficial treatment at an earlier stage. Even when dementia is detected early, neuroimaging investigations should be made to correctly identify the underlying pathology, such as Alzheimer's disease, vascular dementia, dementia with Lewy bodies, or frontotemporal dementia. 6 Chronic illnesses including diabetes mellitus, hypertension, and depression are closely related to dementia. 4 Thus, optimisation of these chronic illnesses may reduce the risk and impact of dementia. Furthermore, poor monitoring of private residential care homes for the elderly, along with nonstandardised care, may aggravate risks of infection 7 and falls, both of which are commonly seen in residents of such facilities. Fall episodes often lead to hip fractures, which are closely linked to sarcopenia 8 and excess mortality 9 .