At the Centre for Ageing Research & Education (CARE), we adopt a multidisciplinary perspective in our research on the determinants of longevity and healthy longevity. Our research, strongly focused on social determinants of health, helps identify demographic, social, psychological, physical, and economic factors that impact morbidity, mortality, and other transitions at older ages. CARE collects population-level data through both cross-sectional and longitudinal community-based surveys, several of which are nationally representative. These data allow us to assess the prevalence, correlates, mediators, and moderators of various health and wellbeing outcomes, and inform policy and practice. Our research addresses eight core themes: Population Health, Family Caregiving, Community-Based Health and Social Care Services, Productive Ageing, Falls, Ageing and the Environment, Health Communication, and Social and Psychological Aspects of Ageing.
Research Themes
Population health encompasses the health outcomes of the whole population and the distribution of health outcomes across different population sub-groups. Measures of population health at older ages include health expectancy, i.e., the number of years of remaining life that older adults on average can expect to live in different states of health, prevalence estimates for various morbidities, health-related limitations in activities of daily living, indicators for mental health such as cognition and depressive symptoms, and social health indicators such as social networks and loneliness. Longitudinal data from our national studies of older adults allows us to track wellbeing indicators over time and identify the determinants of change in these indicators. The data also allows us to identify specific sub-groups of older adults defined by age, sex, ethnicity, socioeconomic status, or health status, who are at greater risk of adverse health and wellbeing outcomes. CARE has linked survey data from some of its national studies with administrative data held by the Ministry of Health, Singapore to further assess population-level segmentation, enable projections of health status and unmet health and social care needs, and examine the correlations between patterns of healthcare utilization.
Family caregiving for older adults is a complex, multifaceted experience, shaped by cultural, social, and family dynamics as well as government policies and programs. Family caregivers provide significant long-term care and assistance to their loved ones, and often engage in several aspects of care, including direct physical and emotional care, decision-making, and coordination with or supervision of other caregivers, including migrant domestic workers. The care trajectory is seldom linear and straightforward, often filled with transitions and challenges. The impact of family caregiving is wide ranging and varied, and caregivers experience both challenges and rewards throughout their caregiving journey. At CARE, our research examines both the positive and negative aspects of caregiving as well as family dynamics in caregiving. We also study how health and social care services, policy, and support for family caregivers can be improved to recognize and validate the important role of family caregivers. We collect data on working caregivers and ‘sandwiched’ caregivers who must balance multiple responsibilities in the home and at the workplace and aim to inform supportive employment policies such as Eldercare Leave and Flexi-Time work.
As Singapore ages, community-based health and social care services are being re-imagined and expanded to reflect the unmet needs and aspirations of current and future older adults in Singapore. Using quantitative and qualitative methods, we examine the barriers and facilitators of the use of long-term care services in Singapore. We also evaluate models of care for older adults and their caregivers, to provide evidence for policy makers and community partners developing long-term care services in Singapore. Our work provides a deeper understanding of the models of health and social care services (e.g., dementia day care, use of community nurses, and eldercare centers) being delivered in Singapore. In doing so we identify the unmet needs or challenges that older adults and their families encounter when receiving health and social care services in the community. Our research aims to provide evidence to inform the development of best practices for long-term care services that integrate both health and social care within the community.
The concept of productive ageing emphasizes the contribution of older adults to their own lives, to their families and communities, and ultimately to society. Productive ageing covers a wide range of activities that older adults can participate in and technologies that they can use to improve their quality of life. Understanding how older adults aspire to be productive and generative and their diverse forms of engagement will inform the development of age-inclusive social policies. At CARE, our research topics cover digital technology use, social engagement, generativity, volunteering, and life-long learning for older adults. Our work ties in with older-adult specific initiatives being undertaken in Singapore under the Action Plan for Successful Ageing.
The risk of falls and fall-related problems increases with age, and accounts for serious disability issues among older adults. Fall prevention is an important part of geriatric care and ageing research. The management of falls can be complicated, with a wide range of contributing factors: the health of older adults, the role of and extent of care provided by household members, and aspects of age-friendly living environment design. CARE conducts research on the determinants of falls at the population level using national longitudinal survey data. It also examines the fidelity and the efficacy of different modes of fall prevention interventions such as peer-led community-based groups, gamification, and health technology.
The environment plays an important role in determining the physical, social, and mental capacities of individuals as they enter and progress through old age as well as in moderating (or enhancing) the impact of decline in intrinsic capacity. At CARE, we examine the diverse ways in which the older individuals interact with their environment and how life space affects healthy ageing. Taking a broader view, the environment includes consideration of those factors that shape public understanding about what it means to age, such as discourses of ageing, cultural references, frameworks of ageing, and forces that mediate the processes and perspectives of ageing.
Health communication is an essential component of healthcare services, as good communication between healthcare providers and patients can contribute to successful treatment and patient satisfaction. Health communication also encompasses advocating for the health needs of care recipients across diverse care settings. Especially within an ageing community, effective health communication needs to be delivered flexibly to provide quality care and services. CARE’s research includes projects and studies to improve the process of health communication between older adults and health and social care professionals, in order to maintain and improve the quality of care services and health outcomes.
Social (for example, social engagement, social relationships, and loneliness) and psychological factors (for example, mental well-being, resilience, and stress) play a critical role in informing how adults cope with and adapt to transitions in their later lives. A comprehensive understanding of the social and psychological factors of ageing is needed to influence better health and well-being outcomes of older adults. At CARE, we analyze the complex interactions and relationships between these factors of ageing. Research supported and conducted by CARE helps identify positive factors that benefit physical, cognitive, and mental health of older adults as well as risk factors for morbidity, mortality, and other age-related challenges.