Ippt for Seniors Detects Frailty at Early Stage
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MAY JUN 2018 THE FLAGSHIP PUBLICATION OF THE SINGHEALTH DUKE-NUS ACADEMIC MEDICAL CENTRE MCI (P) 039/04/2018 WWW.SGH.COM.SG | WWW.SINGHEALTH.COM.SG IPPT FOR SENIORS DETECTS FRAILTY AT EARLY STAGE P3 06 Artificial intelligence in eye care 08 More pre-hospital emergency care ahead 17 Why he’s called the ‘Mad Scientist’ 21 PHOTO: ANGELA GUO PHOTO: When teenagers still wet their beds SH51 00 Cover.indd 1 17/04/2018 16:22 Upon approval Please sign: image<200dpi 161 dpi Name and Date: 02 SINGAPORE HEALTH MAY–JUN 2018 PUBLISHERS CO-PUBLISHERS ® CONTENT ADVISOR Tan-Huang Shuo Mei Group Director, Communications & Service Quality, SingHealth EDITORIAL TEAM Angela Ng (SGH) Lim Mui Khi (SGH) Ann Peters (SingHealth) Read Singapore Health online at www.singhealth.com.sg/SingaporeHealth PUBLISHING AGENT SENIOR EDITOR Dora Tay EXECUTIVE SUB-EDITOR Leonard Lau CREATIVE DIRECTOR Alex Goh ART DIRECTOR Winnie Ong GENERAL MANAGER Maureen Ho HEAD, ADVERTISING SALES Stanley Gan SENIOR EXECUTIVE, CLIENT MANAGEMENT Neo Pei Shi ASSISTANT MANAGER, PUBLISHING SERVICES Rahmah Aman For editorial enquiries, please email [email protected] For advertising enquiries, please call 6571-7143 or email [email protected] All rights reserved. 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Printed in Singapore by Times Printers (registration no. 196700328H). SH51 02 Glory Box.indd 2 17/04/2018 16:22 Upon approval Please sign: image<200dpi 161 dpi Name and Date: MAY–JUN 2018 SINGAPORE HEALTH NEWS 03 Catch them before they fall Hospitals and community services are partners in running a fitness test to detect the early signs of frailty in senior citizens, before they become vulnerable to serious health problems. By Eveline Gan ROWING OLD AND BECOMING weak aged 55 and older at risk of frailty. likelihood of the last 10 years of life being living in the community, so that targeted and frail oft en seem to go together. The Individual Physical Proficiency spent in disability,” said Dr Laura Tay, interventions can happen [before they GBut frailty doesn’t have to be a Test for Seniors (IPPT-S) – much like Senior Consultant, Department of General end up in hospital].” consequence of growing old. And even the physical fitness test for national Medicine, SKH. A pilot run of the IPPT-S done in for those who have begun showing signs servicemen – assesses the flexibility, According to Associate Professor Ng June-July 2017 and involving 100 senior of weakness, the condition can be turned range of motion, strength, balance, Yee Sien, Senior Consultant, Department residents in the Rivervale neighbourhood around with better nutrition, exercise and coordination and endurance of older of Rehabilitation Medicine, SGH: “The of Sengkang picked up a number of frail greater social interaction. people, and is conducted in partnership development of frailty as one ages is very and pre-frail seniors. Prof Ng said 30 For that reason, a team from with community partners and volunteers. subtle, and oft en goes unnoticed until a per cent of the participants were found Singapore General Hospital (SGH) and “While Singapore’s life expectancy is health crisis occurs. to be in the pre-frail and 2 per cent in the Sengkang General Hospital (SKH) has one of the highest in the world, people “Based on evidence-based practices, frail stages. developed a simple but comprehensive living longer may not be mirrored by the IPPT-S programme aims to identify screening programme to identify people them living healthier in old age, with the the robust, pre-frail and frail in the elderly Comprising nine THE DEVELOPMENT OF fitness stations, the Individual Physical FRAILTY... IS VERY SUBTLE, Proficiency Test for AND OFTEN GOES Seniors or IPPT-S measures fitness UNNOTICED UNTIL A indicators such as flexibility, endurance, HEALTH CRISIS OCCURS. strength, balance and ASSOCIATE PROFESSOR NG YEE SIEN, SENIOR coordination. Those CONSULTANT, DEPARTMENT OF REHABILITATION who do not meet the MEDICINE, SGH “Pass” requirements are considered to be frail or at the pre-frail stage. For example, A questionnaire – a part of the test the grip strength test, that looks at nutritional status, ability which Mr Loy See Wee to perform daily living activities, and is doing in this picture, other health aspects such as mood and gauges upper-limb strength and general cognition – found that more than 22 per physical health. Mr Loy cent were at risk of being malnourished, is in his late 60s. while more than 26 per cent might be depressed. Both malnutrition and depression can significantly contribute to frailty. For instance, an elderly person who is malnourished is seven times more likely to suffer from frailty than someone who isn’t. Studies have shown that frailty, Identifying the robust, pre-frail when detected early, is reversible with and frail in the lifestyle changes such as exercise, neighbourhood’s nutritional support and cognitive elderly will facilitate interventions. “In other words, we timely, targeted can help these seniors make lifestyle intervention. PHOTOS: ANGELA GUO > Continued on page 4 SH51 03-04 Cover Story/IPPTS.indd 3 13/04/2018 16:21 Upon approval Please sign: image<200dpi 161 dpi Name and Date: 04 NEWS SINGAPORE HEALTH MAY–JUN 2018 > Continued from page 3 Catch them before they fall changes to nip any problems before a vital role in community screening activities, One of the their conditions get more complex,” said said Prof Ng. fitness tests Prof Ng. “From the word ‘go’, we wanted to work includes a The IPPT-S provides an objective with community partners like AMKFSC 10m walk to assess measure of the physical fitness of the for both screening and post-screening the strength elderly, and comprises nine tests that take follow-up activities,” he said, adding and general about 30 to 40 minutes to complete. that these organisations will conduct the health of the For example, a six-minute walk gauges IPPT-S at their senior activity and day participant. the level of endurance, while the 10m walk rehabilitation centres in housing estates assesses strength and general physical for the convenience of their residents. health. The back-scratch test, where one Community partners and volunteers hand reaches over the shoulder to touch will also be trained to follow up with the other which is placed behind the back, participants, including running structured indicates upper limb flexibility. exercise and nutrition programmes Other tests include 30-second co-developed with SKH. chair stands, a grip strength test, and a modified sit-and-reach test performed while seated on a chair. Upon completing the programme, Frailty red flags participants receive a Pass, Silver or A frail older person may experience three or more of the Gold award and a health booklet of their following symptoms, said Associate Professor Ng Yee results. Those who do not meet the “Pass” Sien, Senior Consultant, Department of Rehabilitation requirements are considered to be frail or Medicine, SGH. Those who experience one or two signs pre-frail, and will be referred to primary are considered to be in the pre-frail stage. health or specialist care for further assessment and follow-up. • Unintentional weight loss every task feels like it In the next three years, the team hopes of at least 4.5kg in the requires a huge eff ort to reach out to at least 2,000 seniors past year • Low level of physical living in the eastern part of Singapore • Feeling weak, having activity, including things that the SingHealth Regional Health diff iculty standing or such as housework and Systems serve. climbing stairs unassisted exercise Social services like AMKFSC, which • Feeling so exhausted that • Slow walking speed was a partner in the pilot project, will play SH51 03-04 Cover Story/IPPTS.indd 4 Upon approval 13/04/2018 16:26 Please sign: image<200dpi 161 dpi Name and Date: MAY–JUN 2018 SINGAPORE HEALTH NEW FRONTIERS 05 Diabetes and obstructive sleep apnoea seem to go together Greater public awareness of the possible links between type 2 diabetes and obstructive sleep apnoea is needed to help patients with either condition better manage their health. By Lediati Tan F YOU HAVE TYPE 2 DIABETES, there is a chance that you might also be Isuff ering from obstructive sleep apnoea (OSA), a sleep disorder in which the patient experiences pauses in breathing and loud snoring throughout the night. No firm link has been established, but studies have suggested an association between the two conditions: people with diabetes tend to have OSA, and vice- versa. Diabetics with OSA also tend to have a poorer ability at controlling their blood sugar levels. Still, people suffering from either condition should be wary of the possibility of the other developing, doctors from the SingHealth Duke-NUS Sleep Centre warned. “We know that lots of patients with OSA may not know they have OSA, including those with diabetes.