Facing the Forgotten: Dismantling Dementia Stigma in Malaysia

The Department is delighted to announce that the Malaysian Public Health Medicine Specialist Association (PPPKAM) has awarded its Research Grant 2024/2025 to Assoc. Prof. Dr. Nik Daliana Nik Farid and her research team, Dr. Siti Sarah Fadzil (DrPH candidate 2023/24), Dr. ‘Abqariyah Yahya, and Prof. Dr. Shahrul Bahyah Kamaruzzaman, on their proposed research project entitled “Determinants of Public Stigma on Dementia Among Community-Dwelling Malaysian Adults” (Validation of Public Stigma on Dementia Questionnaires). This grant recognises their exceptional proposed research project, which promises to contribute significantly to the field of public health in Malaysia. The official announcement was made through the PPPKAM website on May 6, 2024.

As the world’s population ages, the prevalence of dementia cases is increasing, with a projection of 152.8 million cases worldwide by 2050, with more than 60% of people with dementia (PwD) living in low- and middle-income countries (LMIC). However, 75% of dementia cases remain undiagnosed, mainly due to the public stigma against dementia, which contributes to various health, social, and economic consequences. Despite this alarming problem, less than 30 studies have been conducted to assess the public stigma on dementia globally, with the majority conducted in Western countries. Many studies on dementia in Malaysia have focused on the identification and clinical management of dementia. No studies on public stigma and social response to dementia have been conducted in Malaysia for the last decade. Therefore, questions arise as to whether the level of public stigma among community-dwelling Malaysian adults is as high as reported in other studies from Western countries, and if so, what are the factors associated with public stigma on dementia among community-dwelling Malaysian adults?

Previous meeting conducted between the research team

This research project will be conducted in two phases: Phase 1 will involve translation, validation, and reliability testing of the Malay version of the Dementia Knowledge Assessment Scale (DKAS-M) and the Dementia Public Stigma Scale (DePSS), while Phase 2 will involve a cross-sectional study using the validated questionnaires from Phase 1 to determine the level of public stigma on dementia and its associated factors among the study population. The participants will be recruited from community-dwelling Malaysian adults attending the Ministry of Health’s (MOH) primary care health services in Selangor through community outreach programmes and through health clinics selected by simple random sampling. In 2022, Malaysia’s primary care health services recorded up to 40 million outpatient visits, encompassing not only adults with chronic conditions but also their families and other community members, reflecting the diverse demographics of the general public within these settings. This reflects huge opportunities to initiate dementia education and plan interventions to destigmatize the disease in primary care settings. Even though there is no known treatment for dementia, it can be delayed, and effective control of its risk factors as part of dementia risk reduction strategies should be initiated at the primary care level. Primary data collection will be performed via validated, bilingual self-administrated questionnaires distributed in hardcopy and softcopy formats.

The research proposal was also previously presented to the Public Health Medicine Specialists from the Elderly Health Sector, Family Health Development Division, Ministry of Health Malaysia.

This research project aims to highlight the importance of understanding the prevailing societal stigmatising stereotypes, prejudices, and discriminatory behaviours towards PwD, their families, and care partners. In addition, the identification of factors that are associated with the public stigma on dementia will provide further insights into potential barriers to social inclusion for PwD. This study will also help to pinpoint the importance of creating dementia-friendly, supportive, and inclusive communities for PwD to ensure that they can lead a better quality of life and positive health outcomes. The findings from this study hope to assist policymakers in understanding the gravity of the problems, designing targeted public awareness and health campaigns on dementia, stigma-reduction strategies, and better resource allocation. Most importantly, this research project is a reactive response to the global call to reduce stigma against PwD, which has been around for many years. We extend our best wishes to the research team in carrying out the research project.

Early engagement for better dementia understanding and dissemination of research findings with Alzheimer’s Disease Foundation Malaysia (ADFM), a member of Alzheimer’s Disease International (ADI), From left: Dr. Siti Sarah Fadzil, Datuk Dr. Yim Khai Khee (ADFM Chairman), and Ms. Jenny Lim (ADFM Resource and Training Manager).

 Article was written by Dr Siti Sarah Fadzil, Year 1, Doctor of Public Health candidate.

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