SINGAPORE : Just when does irritability become a sign of depression and how do you know when an elderly person is sliding into dementia?

These are the sort of skills a pilot programme at Changi General Hospital hopes to equip people in the frontline of eldercare with.

By the year 2030, almost one in five persons in Singapore will be aged 65 and above.

But what worries medical authorities is not just the physical problems they will have, but also mental issues.

A recent survey shows more than 5 percent of those aged 60 and above have dementia - with the figure for depression being 3.1 percent.

Mental problems among the elderly in Singapore are not uncommon but they tend to face three big issues.

They are either undiagnosed - for example, irritability which could be a sign of depression.

Or they are under-diagnosed - for example, one could have forgetfulness which is a sign of a bigger problem.

Or they are completely mis-diagnosed - they think an old person is just senile when dementia is setting in.

And the problem is that by the time they come to the hospital, the situation is already chronic.

Hoping to alleviate this situation is the newly-launched Community Pyschogeriatric Programme.

The fact is there are few trained psychiatrists in the area of elderly mental health.

This is why the first phase of the programme is to train GPs and staff of eldercare agencies to detect and manage health problems in the elderly.

Secondly, build a community network linking these agencies, GPs and hospitals so that referrals can be made.

Thirdly, make home visits for those unable or unwilling to come out.

Eventually it is hoped that the stigma associated with mental problems will fade.

T K Udairam, CEO, Changi General Hospital, says: "You have communities in America or Europe where going to a psychologist or psychiatrist is just as the same as going to a dentist - not as pleasurable but something that you recognise."

This programme will initially cover areas under the North East and South East CDCs and will progressively be extended to the whole country.

An Institute of Mental Health team will set up a programme for the central region by 2008 while a team at Alexandra Hospital will set up a programme for the west by 2009.

Welcoming this, Minister-in-Charge of Ageing Issues Lim Boon Heng added that older people needed to remain mentally active.

He said: "So how do we get people to remain mentally active? I think the studies by the NUS team that was recently released shows the best way is to remain purposely engaged, meaning you do something for which there is a purpose. So, a housewife who continues to cook derives a certain satisfaction and sense of achievement even if it is an ordinary day-to-day thing. People who continue to work have a purpose in life and exercise their minds everyday."

And so, national mental games competitions will be organised next January in six fields - sudoku, international and Chinese chess, bridge, mahjong and scrabble. - CNA/ch