With the global ageing population, including that in Hong Kong, the well-being of older adults has emerged as a significant social issue. The prevalence of common illnesses among older adults, particularly dementia, is a major societal concern. Hong Kong Metropolitan University (HKMU) collaborated with Hong Kong Lutheran Social Service, LC-HKS (HKLSS) to conduct research titled “Dementia risks among Hongkongese aged 55 or above”. The study collected data from more than 1,000 participants aged 55 or above to assess their risk of dementia, analyse related factors, and gain insights into their awareness of dementia. The findings revealed that individuals with a higher level of education, a healthy lifestyle, or active employment exhibited a lower risk of dementia. Women demonstrated a greater perception of the risk of dementia and tended to adopt a healthier lifestyle than men.

The study commenced in 2021 and was conducted over a period of two and a half years. The research team surveyed 1,102 individuals aged 55 or above, encompassing diverse genders and education levels across various districts of Hong Kong. The first part of the study involved collecting data on the participants' objective health indicators and assessing their risk of dementia by providing the Automatic Retinal Image Analysis (ARIA) assessment service. This involved capturing retinal images and analysing the retinal vascular status with the use of artificial intelligence technology, thereby assessing the risk of dementia. The second part of the study involved the administration of questionnaires to gather data on the participants' subjective health indicators, including dietary and lifestyle habits, as well as knowledge of dementia, to analyse the factors that are correlated with the disease.

Key findings of the study: 

• The retinal images reflected a medium risk of dementia, which was associated with lifestyle habits: Analysis of the retinal images showed that 49.7% of the participants were at “medium risk” of dementia, while 25.8% and 24.5% were at “low risk” and “high risk”, respectively. Over 90% of the participants did not have smoking and alcohol drinking habits. More than half of them had a regular daily exercise routine. However, only about 30% of the participants reported a daily intake of more than one bowl of cooked vegetables, and only about 40% of the participants had a daily intake of one medium-sized fruit. It was found that adopting healthier lifestyle habits contributed to a reduction in the risk of dementia.

• Education and employment status had a significant impact on the risk of dementia: In addition to the well-established association between age and a higher risk of dementia, there was a noteworthy link between the participants' education and employment status, and the risk of dementia. Individuals who were employed either part- or full-time demonstrated a lower risk of dementia than those who were jobless or retired.

HKMU School of Arts and Social Sciences Lecturer Dr Vivian Tsang Hiu-ling said, “Our observations revealed that nearly half of participants were at medium risk of dementia and objectively exhibited intermediate health levels. A majority of them maintained regular exercise habits, highlighting a significant negative association between healthy lifestyle practices and the risk of dementia. However, the lower-educated group displayed a higher risk of dementia. Consequently, we recommend directing efforts towards this group to encourage the adoption of healthy dietary and lifestyle habits.”

• Women had healthier lifestyles than men: The research team also investigated gender differences. Compared to male participants, female participants perceived themselves as less healthy, they reported poorer sleeping quality and higher levels of stress, and had a perceived higher risk of dementia, but a healthier lifestyle. Dr Tsang commented, “We believe that this discrepancy may be attributed to the fact that most women perceive their physical health to be poorer, leading them to actively improve their physical well-being through healthier lifestyle practices.”

The collaborative research project conducted by HKMU and HKLSS was a component of the “Health Infinity” programme, funded by the Bank of China (Hong Kong). The objective of this programme is to facilitate the advancement of primary care. Through this study, the research team aimed to raise public awareness and concern regarding the risk of dementia. The anticipated outcome of the study was to contribute to the formulation of enhanced healthcare policies and measures for older adults. The research team also sought to encourage both the government and the public to prioritise early-stage screening and preventive efforts related to dementia.