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THE SIGNS Study

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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 FINDINGS AND PUBLICATIONS IN THE PRESS STUDY TEAM CONTACT US

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

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THE SIGNS Study Wave 2

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THE SIGNS Study Wave 3a

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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

THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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THE SIGNS Study

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

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STUDY TEAM

SIGNS TEAM
Front Row (Left to Right): Associate Professor Rahul Malhotra, Associate Professor Angelique Chan, Dr Abhijit Visaria
Back Row (Left to Right): Ms Sumithra Devi Suppiah, Ms Meagan Goh
Absent with Apologies: Professor David Bruce Matchar

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

 

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