Principal Investigator:
Chetna Malhotra, Assistant Professor, Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore
Study Team:
Dennis Seow, Tan Lay Ling, Philip Yap, Janhavi Vaingankar, Tong Kamun, Tan Boon Yeow, Tham Weng Yew, Ng Wai Chong, Jason Foo, Eric Finkelstein, John Allen, Truls Ostbye, Rahul Malhotra, Ng Li Ling, Vanessa Mok, Alisson
Sim, Ng Wei Fern, Wong Hon Khuan, Bharathi Balasundaram, Tan Rui Qi, Ong Pui Sim, Wee Shiou Liang, Richard Goveas, Tan Weng Mooi, Luo Danlin
Background:
Dementia affects 10% of the elderly population in Singapore. However, to date there is a lack of systematic information regarding end of life (EOL) care received by patients dying with severe dementia (PDSD), their EOL
direct and indirect costs and caregiver burden. This study is a first-of-its-kind prospective Cohort Study in Singapore to assess comprehensively the care received by PDSD, the annual and EOL direct and indirect costs
for PDSD as well as any influencing factors.
Objectives:
The study aims to assess comprehensively the care received by PDSD, the annual and end-of-life direct and indirect costs for PDSD as well as any influencing factors. We also aim to develop a comprehensive risk score to
accurately predict 6-month mortality in community-dwelling PDSD.
Design:
This is a prospective study of primary informal caregivers taking care of patients with advanced dementia. 312 primary informal caregivers are followed every 4 months for 2 years, or until the patient passes away, and
then post-death 8 weeks and 6 months to assess bereavement of the caregiver. Additionally, we conduct qualitative in-depth interviews with at least 10% of the recruited sample of the caregivers. Treating physicians are
also invited to take part in the study.
Study sites:
Singapore General Hospital
Changi General Hospital
Khoo Teck Puat Hospital
Institute of Mental Health
Jurong Community Hospital
St Luke’s Hospital
Care for the Elderly Foundation
Tsao Foundation
Alzheimer’s Disease Association
Implications:
The results of this study will help to improve early decision making by caregivers regarding end-of-life care and physician referrals for palliative care services; and a better understanding of end-of-life care for PDSD
and their caregivers that will lead to cross-sector collaborations to improve delivery of palliative care to PDSD. In the long term, this study will improve clinical and public health policy and has the potential to be
the foundation for future initiatives for dementia care and improved social and medical infrastructure planning.
Publication/s:
Malhotra C, Vishwanath P, Yong JR, Truls O, Seow D, Yap P, Tan LL, Tham WY, Vaingankar J, Foo J, Tan BY, Tong KM, Ng WC, Allen JC, Malhotra R, Tan WM, Wee SL, Ng LL, Goveas R, Mok V, Sim A, Ng WF, Wong HK, Balasundaram B, Tan RQ, Ong PS, Cheong CY, Yee A, Tiong C, Hum A, Lee A & Finkelstein EA. Journal of Alzheimer’s Disease.2020; 75(2):403-416.
Zain Z, Mohamad H, Seow D, Hum AYM, Allen JC, Tong KM, Malhotra R, Balasundaram B, Malhotra C. Journal of the American Geriatrics Society.2020; 10.1111/jgs.16641
Malhotra C, Hazirah M, Tan LL, Malhotra R, Yap P, Balasundaram B, Tong KM, Pollak KI, PISCES Study Group. Journal of Pain and Symptom Management.2020. Published Online First. doi: 10.1016/j.jpainsymman.2020.11.021
Malhotra, C., Mohamad, H., Østbye, T., Pollak, K. I., Balasundaram, B., Malhotra, R., Tong, K. M., Hum, A., Allen, J. C., Seow, D., Yong, J. R., Yoon, S., & PISCES Study Group (2021). Age and ageing, afab049. Advance online publication. https://doi.org/10.1093/ageing/afab049
Project Start Date:
12 October 2017
Contact Person:
Kat: ekaterina.utkina@duke-nus.edu.sg