THE SIGNS Study

Transitions in Health, Employment, Social Engagement and Inter-Generational Transfers in Singapore Study
(THE SIGNS Study) – Wave 3

This study has been approved by the National University of Singapore Institutional Review Board 
(NUS-IRB Reference Code: NUS-IRB-2022-627)

ABOUT THE SIGNS STUDY


Singapore is an ageing society. Its population of older adults, aged 60 years and older, will continue to increase in the coming decades. The Ministry of Health (MOH), Singapore has funded the Centre for Ageing Research and Education (CARE) at Duke-NUS Medical School to conduct THE SIGNS Study, a nationally-representative, longitudinal study (i.e., survey and follow-up the same set of individuals over time) of older Singaporeans. THE SIGNS Study is collecting comprehensive data on the health and wellbeing of older Singaporeans and the change in these over time.

Information collected in THE SIGNS Study includes indicators of physical and mental health and wellbeing, social engagement and participation, employment, intergenerational relationships, quality of life, and the impact of COVID-19. These national data contribute to the formulation, development, and refinement of policies and the planning of services for older adults in Singapore.

Till date, CARE has completed three waves of data collection in THE SIGNS Study. The first wave (THE SIGNS Study – Wave 1) was conducted in 2016-2017 with 4,549 older adults, of which 2,887 were followed up in the second wave (THE SIGNS Study – Wave 2) in 2019.

THE SIGNS Study – Wave 3 consist of Wave 3a (2023-2024), which followed up with 1,535 older adults from Wave 2, as well as a refreshed cohort of 5,306 older adults in Wave 3b (2024-2025).  

As of 31 Dec 2025, 6,841 participants have been recruited for THE SIGNS Study – Wave 3. These participants will be followed up in Wave 4 starting 2027.

 

FINDINGS AND PUBLICATIONS
FROM THE SIGNS STUDY

THE SIGNS Study - Wave 1 and 2 One-Page Findings Summary

Special Reports

THE SIGNS Study Wave 1

THE SIGNS Study Wave 2

THE SIGNS Study Wave 3a

Publications

  1. Ang, S., & Malhotra, R. (2024). How helping you helps me: A longitudinal analysis of volunteering and pathways to quality of life among older adults in Singapore. The Journals of Gerontology: Series B, 79(5), gbae013. https://doi.org/10.1093/geronb/gbae013
  2. Jung, J. H., Ang, S., & Malhotra, R. (2023). Volunteering, religiosity, and quality of life in later life: Evidence from Singapore. Aging & Mental Health, 27(10), 2078–2087. https://doi.org/10.1080/13607863.2023.2169247
  3. Suppiah, S. D., Malhotra, R., Tan, Y. W., Jessup, R. L., Chew, L. S. T., Tang, W. E., et al. (2023). Prevalence of health literacy and its correlates from a national survey of older adults. Research in Social and Administrative Pharmacy, 19(6), 906–912. https://doi.org/10.1016/j.sapharm.2023.02.013 
  4. Sung, P., Chia, A., Chan, A., & Malhotra, R. (2023). Reciprocal relationship between lifelong learning and volunteering among older adults. The Journals of Gerontology: Series B, 78(5), 902–912. https://doi.org/10.1093/geronb/gbad003
  5. Visaria, A., Aithal, S., & Malhotra, R. (2023). Digital technology use, in general and for health purposes, by older adults in Singapore. Aging and Health Research, 3(1), 100117. https://doi.org/10.1016/j.ahr.2023.100117
  6. Tan, L. T., Østbye, T., Visaria, A., & Malhotra, R. (2022). Derivation, and establishment of the validity and reliability, of the CASP-11-SG quality of life scale among community-dwelling older adults. Quality of Life Research. Accepted August 2022.
  7. Ang, S., & Malhotra, R. (2022). The filial piety paradox: Receiving social support from children can be negatively associated with quality of life. Social Science & Medicine, 303, 114996. https://doi.org/10.1016/j.socscimed.2022.114996
  8. Sung, P., Malhotra, R., Cheng, G. H.-L., & Chan, A. (2022). Transitions in social network types over time among older adults. Gerontology, 68(7), 817–828. https://doi.org/10.1159/000521213
  9. Ping, Y., Visaria, A., Suppiah, S., Tan, Y. W., & Malhotra, R. (2022). Prevalence and correlates of medication reminder app ‘use and use intention’ among older adults. Exploratory Research in Clinical and Social Pharmacy, 6, 100150. https://doi.org/10.1016/j.rcsop.2022.100150
  10. Aithal, S., Visaria, A., & Malhotra, R. (2022). Prevalence, and socio-demographic and health correlates of insufficient physical activity and high sedentary behaviour among older adults in Singapore. Journal of Aging and Physical Activity. Advance online publication. https://doi.org/10.1123/japa.2021-0324
  11. Lai, W. X., Visaria, A., Østbye, T., & Malhotra, R. (2022). Prevalence and correlates of use of digital technology for managing hypertension among older adults. Journal of Human Hypertension. Advance online publication. https://doi.org/10.1038/s41371-022-00654-4
  12. Phua, J., Visaria, A., Østbye, T., & Malhotra, R. (2022). Association of vision and hearing impairments with quality of life: Mediation by psychosocial factors. Geriatrics & Gerontology International, 22(1), 56–62. https://doi.org/10.1111/ggi.14318
  13. Ang, S., Lim, E., & Malhotra, R. (2021). Health-related difficulty in internet use among older adults: Correlates and mediation of its association with quality of life through social support networks. The Gerontologist, 61(5), 693-702. https://doi.org/10.1093/geront/gnaa096
  14. Cheng, G. H.-L., Chan, A., Østbye, T., & Malhotra, R. (2021). Productive engagement patterns and their association with depressive symptomatology, loneliness and cognitive function among older adults. Aging & Mental Health, 25(2), 332-340. https://doi.org/10.1080/13607863.2019.1686458 
  15. Zhou, B., Carrillo-Larco, R. M., Danaei, G., Riley, L. M., Paciorek, C. J., Stevens, G. A., Gregg, E. W., Bennett, J. E., Solomon, B., Singleton, R. K., Sophiea, M. K., Iurilli, M. L., Lhoste, V. P., Cowan, M. J., Savin, S., Woodward, M., Balanova, Y., Cifkova, R., Damasceno, A., … Ezzati, M. (2021). Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: A pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet, 398(10304), 957–980. https://doi.org/10.1016/S0140-6736(21)01330-1 

Book Chapters

  1. Visaria, A., & Malhotra, R. (2023). Common factors in risk of social isolation and use of digital technology by older adults: Insights from Singapore. In Handbook of Aging, Health and Public Policy (pp. 178-1). Springer, Singapore. https://doi.org/10.1007/978-981-16-1914-4_178-1

IN THE PRESS AND MEDIA RELEASE

Sumiko Tan: Friends can boost health, but what if you struggle to keep them?

Read More

Do good, feel good: Singapore survey shows benefits of volunteering

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Seniors who volunteer feel better about their quality of life: Singapore survey

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Older Singaporeans who volunteer perceive a better quality of life, finds study from...

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The Straits Times: New nationwide study to shed light on health, social and mental well-being of seniors

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Commentary: Here are 3 new 'Cs' for an ageing Singapore

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Over-60s suffering more with chronic diseases than a decade ago: Study

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THE SIGNS Study by Duke-NUS researchers identify factors affecting active and productive ageing among older Singaporeans

Read More

STUDY TEAM

CONTACT US

GET IN TOUCH WITH THE SIGNS STUDY TEAM AT CARE

Should you wish to speak to someone from Duke-NUS Medical School about THE SIGNS Study, please contact Ms Sumithra Devi Suppiah or Ms Meagan Goh at:

phone
  • Telephone: 6601 5976 (Ms Suppiah) and 6516 1070 (Ms Goh)
  • WhatsApp: 6601 5976 (Ms Suppiah) and 6516 1070 (Ms Goh)
email

 

DATA REQUEST

THE SIGNS Study data is available upon request to researchers.

 

Quick guide for dataset request

Researchers can request for de-identified data from THE SIGNS Study Waves 1-3 for academic research purposes. The full dataset for THE SIGNS Study will not be shared; only a subset of the dataset, containing the variables that are relevant for answering the research question/s or investigating the research topic/s the researchers are interested in will be shared.

Steps for accessing THE SIGNS Study de-identified data

Step 1: Download the Data Request Form and Data Collection Form (please select the relevant data collection form by waves below).

Step 2: Submit the completed Data Request Form to CARE Data Request
(email: care-datarequest@duke-nus.edu.sg)

Note: CARE may request clarifications from you on the submitted data request form, if necessary.

If an undergraduate or graduate student wants to use THE SIGNS Study data for a research project or thesis then the student’s supervisor must be listed as Requestor 1 (Lead Researcher) in the Data Request Form. The student can be listed as an additional researcher.

Next, permission for sharing the data will be taken from various data owners by CARE, based on the submitted data request form. Please proceed to Step 3 only after CARE has informed you of the permission outcome.

Step 3: Obtain approval from your Institutional Review Board (IRB) or ethics review board for the analysis of de-identified survey data from THE SIGNS Study.

  • If you require a supporting letter from THE SIGNS Study researchers in support of your IRB or ethics review board application, please download the supporting letter template, fill in your name, institution and study name and submit it to the CARE Data Request email
  • If the content of the supporting letter needs to be modified, please send your request to the same email

Step 4: Upon approval of your IRB or ethics review board application, please submit the IRB or ethics review board approval letter and the approved IRB or ethics review board application form/protocol to the CARE Data Request email for our reference

Step 5: Sign the non-negotiable Letter of Undertaking (to be signed by the lead researcher, and his/her institutional representative).

Step 6: You will receive the dataset either in person or via a secure cloud-based link

 

StudyIRB Approval Reference NoRelevant Documents
THE SIGNS Study Wave 1 

Participant Information Sheet (PIS)

Consent Form (CF)

 

Data Collection Form

THE SIGNS Study Wave 2 

Participant Information Sheet (PIS)

Consent Form (CF)

 

Data Collection Form

THE SIGNS Study Wave 3a 

Participant Information Sheet (PIS)

Consent Form (CF)

 

Data Collection Form

THE SIGNS Study Wave 3b 

Participant Information Sheet (PIS)

Consent Form (CF)

 

Data Collection Form

 

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