Community Health Intergenerational (CHI) Study

CHI Research Study

The increasing interest in Ageing-in-place led to the start of a new research project on community-dwelling seniors.

This Community Health Intergenerational (CHI) study uses a multi-disciplinary approach to gather comprehensive biological, psychological, and social health profiles of older adults living in public housing estates. The study aims to: 

  • Investigate the concept of ageing in place by examining the resiliency and vulnerability factors of the ageing process. 
  • Examine intergenerational bonding and community support.

View all our publications here.

Family Intergenerational Bonding Study

Narrative and reminiscence intervention (NRi) to Improve Family Intergenerational Bonding

Reminiscence-based intervention is a narrative and reflective process that uses the recall of past experiences to enhance positive feelings, coping mechanisms, and adaptation to ageing in older adults. 

The study first started with a systematic review to evaluate the existing evidence on the effects of the reminiscence-based intervention on psychological outcomes in cognitively intact older adults. A pilot randomized controlled trial (RCT) was then conducted to examine the feasibility of a narrative and reminiscence intervention (NRi) to improve intergenerational relationships, subjective well-being and quality of life among community older adults. A follow-up process evaluation was conducted to assess the acceptability, strengths and limitations of the intervention based on the participants’ perspectives.

While a larger-sized RCT is necessary, our pilot study found a positive impact of NRi on intergenerational relationships, family cohesion, quality of life, subjective well-being and loneliness. Furthermore, participants reported that they enjoyed the intervention, thus showing great potential for success when scaled for the community as a whole.

Read the published article here.

Shape of Youth - NUS Mind Science Centre
CHI Family Portrait

Impacts of COVID-19 and partial lockdown on intergenerational communication

The study aims to examine the factors associated with family functioning among young adults in Singapore during the COVID-19 pandemic through a cross-sectional online survey. Family functioning refers to the quality of interactions among family members and consists of cohesion, flexibility and communication. 

Our study results suggested that family functioning is significantly associated with intergenerational communication and satisfaction with social support in a pandemic. Participants with balanced levels of cohesion and flexibility in their families are more likely to be able to cope with the psychological impacts of the pandemic. 

The findings serve to inform intervention and preventive efforts to improve family functioning and reduce the risk of psychological distress in a pandemic.

Read the published paper here.

Brief Integrated Personal Therapy (BIPT) - “Where there is no psychiatrist”

The prevalence of both subsyndromal depression (SSD) and/or subsyndromal anxiety (SSA) in older adults has been increasing. However, mental health still has a negative connotation and adults with mental health conditions often delay seeking help. Above that, there is also a lack of psychiatric services. The psychiatrist-to-population ratio in Singapore only 2.6 per 100,000, as compared to other developed countries like Australia (14 per 100,000) and the UK (11 per 100,000).

This study is aimed to monitor the feasibility in the aspects of participant recruitment, retention and acceptability, as well as to examine the preliminary efficacy of the ‘BIPT-Where there is no psychiatrist’ intervention provided by lay trained volunteer(s) to the community-dwelling older adults with SSD and/or SSA. The intervention is made up of a 30-minute mindfulness session, followed by a 60-minute solution-focused brief therapy (SFBT) involving psychoeducation and structured life review therapy. 

Our study found a significant increase in the quality of life of the older adults who underwent the BIPT intervention. Participants also reported having improved moods and a more positive outlook in life.

Read the published paper here.

Community Health Integrational

Dietary Counselling Study

CHI Study

This study was a 24-week randomized controlled trial (RCT) which aims to evaluate the effects of providing comprehensive dietary counselling on dietary quality, cardio-metabolic health, mental health, sleep quality, and quality of life in Singapore female older adults.

Findings from this study will act as practical guidance for dietary behaviour changes providing cardiometabolic and mental health-promoting effects to a large proportion of the Singapore population. There is a rapid ageing epidemic in Singapore and the cost and manpower for ageing-related health condition care is becoming unsustainable. This study can support dietary counselling programme development to enhance the well-being and healthy ageing of the Singapore community.

Read the published article here.

Olfactory dysfunction is associated with mild cognitive impairment in community-dwelling older adults

Olfactory impairment is ageing related and is associated with cognitive decline in older adults. However, it remains unclear if an olfactory impairment is associated with mild cognitive impairment (MCI) and the degree of impairment in the MCI subtypes.

In a cohort of community-living older adults aged 60 years and above, 670 participants were recruited from the CHI Study. Olfactory function was assessed using a locally developed nine-item smell test in association with neurocognitive assessments.

Our study found that the mean smell identification score of MCI participants was not significantly different as compared with NA, but an amnestic MCI multiple domain (aMCI_MD) subgroup had significantly lower (impaired) mean smell identification scores compared with the NA and MCI single domain (amnestic and non-amnestic) group.

This suggests that olfactory impairment in the aMCI_MD deficits subgroup might be a potential baseline risk factor for predicting AD in later life. The locally developed smell test could benefit clinicians and researchers as a supplementary tool for identifying those with smell impairment at preclinical stages of cognitive decline, which could timely slow down or curb the progression to dementia. Read our publication here.

Community Health Integrational Study

Volunteerism in Older Adults Study

CHI on Dementia Prevention

Singapore’s ageing population trend translates into challenges for the economy and healthcare service system. This emphasises the need for an accessible, population-level intervention to tackle those challenges. 

One such solution is volunteerism as research has found an association between volunteering in later years with better cognition, physical health, and mental health. Furthermore, engaging seniors as volunteers could substantially impact an array of unmet societal needs as they represent a significant and underutilized human and social capital.

With participants recruited from the CHI and Jurong Ageing Study (JAS), this study aims to examine the association between volunteerism in the older population and health outcomes. The second aim is to investigate social and neural signalling biomarkers such as oxytocin, vasopressin and brain-derived neurotrophic factor (BDNF) in relation to volunteerism, as it is hypothesized that biological markers will influence volunteering behaviour. Finally, factors such as personality, prosocial attitudes and cognition, childhood experiences, religion/spirituality and their influence on volunteering behaviour will be examined.

Data analysis and report write-up for publication are ongoing. More information will be coming up soon.

Wearable Sensors Study

This study aims to explore the effectiveness of wearable sensors and phone applications in increasing physical exercise engagement. It will also allow us to determine whether exercise is effective in helping to delay or reverse cognitive and physical decline in older adults. 

Participants are randomly assigned to either a control group or an intervention group. They will take a neurocognitive assessment as well as a questionnaire at three time points: at the start of the study (Baseline), 3 months into the study (T2), and 6 months into the study (T3). We hypothesize that the intervention group will have higher levels of physical activity engagement resulting in improved cognitive and physical outcomes at T2 and T3. 

The result of this study could justify the use of technology in physical activity engagement as a preventive measure for the elderly at risk of cognitive frailty. Such self-management solutions could aid in overcoming the constraints of a healthcare system strained by a rapidly ageing population.

We are still recruiting participants to join this study. For more information, please see the poster here or contact Joel at joelng@nus.edu.sg or 97710520.

CHI on Congnitive Impairment

Impact of Protein Intake on Sleep Quality Study

CHI research Study on Active Ageing

Today, insufficient sleep has become a growing global problem. Sleep is essential to health and changes in sleep patterns are a part of the ageing process. Inadequate and low-quality sleep also increases the risk for age-related cognitive decline and disease conditions. More importantly, due to the COVID-19 pandemic, there is a significant increase in psychological distress and symptoms of mental illness and subsequent worsening of quality of sleep. As such, there is an urgent need to investigate the way of improving sleep quality, in particular during and in the post-COVID-19 period, especially in older adults. 

One of the possible strategies to improve sleep quality with lifestyle modification is having a higher-protein diet. However, this effect has not been fully elucidated in older adults. In addition, the effect of the type of dietary protein on sleep quality is inconclusive and there is no clinical trial which assessed the differential response in sleep quality between animal-sourced protein vs. plant-sourced protein. Therefore, this research project aims to assess the impact of different types of higher dietary protein intake on sleep quality in Singaporean older adults.

The research team is currently awaiting IRB approval and the research is expected to start in Aug 2022. Keep up to date with the progress of this research by joining our mailing list.