Malaysia's urgent need to enhance dementia care facilities amid aging crisis

Malaysia is still developing its infrastructure to effectively manage the rising number of dementia patients.

KPJ Sentosa KL Specialist Hospital, Consultant Physician Geriatrician and Associate Professor Dr. Yau Weng Keong highlighted the urgent need to enhance facilities and improve the healthcare system to better meet this growing demand.

He added that Malaysia is undergoing significant demographic changes and is set to become an aged society by 2030, presenting a more challenging situation compared to other countries.

“For instance, it took France 115 years to double its population from 7 million to 14 million, whereas Malaysia achieved this in just 28 years.

“Many countries with advanced systems are well-prepared to handle such changes, having built robust infrastructures over time.

“As Malaysia continues to develop, it is crucial to address the growing number of dementia patients and enhance our healthcare system accordingly."

He added that the nation’s resources for elderly care are limited, with a shortage of geriatric specialists. As a geriatrician, he noted that their role involves extensive patient interaction and explanation rather than procedures, which often leads to lower earnings compared to other medical fields, making it less attractive for new professionals.

Dr. Yau revealed that in 2018, Malaysia had only 40 geriatric specialists, and by 2024, the number has increased to 60. Despite this growth, the number remains relatively low compared to other countries.

He also highlighted that Malaysia’s ratio of geriatricians is 0.019 per 1,000 people, significantly lower than the UK. This discrepancy means the UK has four times as many geriatricians who are well-equipped to handle elderly care.

In terms of nursing, Malaysia has 71,000 nurses and 44,000 beds, resulting in a ratio of 1.5 nurses per bed in contrast, the UK has a ratio of 3.09 nurses per bed. He added that Malaysian nurses are often overworked, underpaid, and underappreciated.

Dr. Yau also pointed out that facilities for the elderly are inadequate, with staff shortages and limited coverage in certain areas. He emphasised the need for Malaysia to train 600 geriatricians to improve planning, service, and management.

“Without proper preparation and planning, the country may face significant challenges as the elderly population grows,” he added.

When asked about recent developments and ongoing research in dementia, Dr. Yau highlighted that Malaysia is actively engaged in various studies, including medication, therapy, and disease modification.

Notably, the Genting Group is involved in research on TauRx aggregation inhibitors and is exploring methylene blue for its potential in preventing TauRx aggregation. For the uninitiated, tau aggregation inhibitors are designed to prevent or disrupt the process of tau protein misfolding and aggregation in neurodegenerative diseases.Tau protein is neurofibrillary tangles associated with Alzheimer's disease.

At one point, Genting Group's stock price rose in response to anticipated results from this research. This reflects Malaysia's significant involvement in advancing dementia research.

He also noted that in the US, there are advancements in immunotherapy for Alzheimer's disease. A specific treatment involves an injection that targets and clears amyloid plaques from the brain, reducing their presence.

Last year, Dr Yau said the Food and Drug Administration (FDA) expedited approval for such a drug, despite it facing controversy. Recently, a new drug called Lecanemab has emerged, which also works to lower beta-amyloid levels through regular injections. This treatment aims to prevent the progression to dementia, reflecting ongoing efforts to address Alzheimer's disease.

“In Malaysia, there is a limited range of medications available for dementia, with only a few new drugs introduced over the past 20-30 years.

“Developing new medications is challenging and costly, with each drug potentially costing around RM800,000,” he said.

Dr Yau Weng Keong is a leading Consultant Physician Geriatrician at KPJ Sentosa KL Specialist Hospital, dedicated to elderly care. Previously, he was Head of Geriatric Services at Hospital Kuala Lumpur (HKL), where he expanded services nationwide, except in Terengganu and Perlis.

His qualifications include an MD from USM, MRCP(UK), CMIA(Msia), and FRCP(Lond). His past roles also include leading Geriatric Services at the Ministry of Health, Malaysia, heading HKL's Medical Department, and lecturing at Taylors University's School of Medicine.