The Aging of a Young Nation: Population Aging in Singapore

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Abstract

The juxtaposition of a young city-state showing relative maturity as a rapidly aging society suffuses the population aging narrative in Singapore and places the "little red dot" on the spotlight of international aging. We first describe population aging in Singapore, including the characteristic events that shaped this demographic transition. We then detail the health care and socioeconomic ramifications of the rapid and significant shift to an aging society, followed by an overview of the main aging research areas in Singapore, including selected population-based data sets and the main thrust of leading aging research centers/institutes. After presenting established aging policies and programs, we also discuss current and emerging policy issues surrounding population aging in Singapore. We aim to contribute to the international aging literature by describing Singapore's position and extensive experience in managing the challenges and maximizing the potential of an aging population. We hope that similar graying populations in the region will find the material as a rich source of information and learning opportunities. Ultimately, we aspire to encourage transformative collaborations-locally, regionally, and internationally-and provide valuable insights for policy and practice.

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Most cited references 22

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Multimorbidity in older adults.

M Salive (2013)

Multimorbidity, the coexistence of 2 or more chronic conditions, has become prevalent among older adults as mortality rates have declined and the population has aged. We examined population-based administrative claims data indicating specific health service delivery to nearly 31 million Medicare fee-for-service beneficiaries for 15 prevalent chronic conditions. A total of 67% had multimorbidity, which increased with age, from 50% for persons under age 65 years to 62% for those aged 65-74 years and 81.5% for those aged ≥85 years. A systematic review identified 16 other prevalence studies conducted in community samples that included older adults, with median prevalence of 63% and a mode of 67%. Prevalence differences between studies are probably due to methodological biases; no studies were comparable. Key methodological issues arise from elements of the case definition, including type and number of chronic conditions included, ascertainment methods, and source population. Standardized methods for measuring multimorbidity are needed to enable public health surveillance and prevention. Multimorbidity is associated with elevated risk of death, disability, poor functional status, poor quality of life, and adverse drug events. Additional research is needed to develop an understanding of causal pathways and to further develop and test potential clinical and population interventions targeting multimorbidity. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health 2013.

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The Epidemiologic Transition: Changing Patterns of Mortality and Population Dynamics.

Robert McKeown (2009)

The epidemiologic transition describes changing patterns of population age distributions, mortality, fertility, life expectancy, and causes of death. A number of critiques of the theory have revealed limitations, including an insufficient account of the role of poverty in determining disease risk and mortality, a failure to distinguish adequately the risk of dying from a given cause or set of causes from the relative contributions of various causes of death to overall mortality, and oversimplification of the transition patterns, which do not fit neatly into either historical periods or geographic locations. Recent developments in epidemiologic methods reveal other limitations. A life course perspective prompts examination of changes in causal pathways across the life span when considering shifts in the age distribution of a population as described by the epidemiologic transition theory. The ecological model assumes multiple levels of determinants acting in complex and interrelated ways, with higher level determinants exhibiting emergent properties. Development, testing, and implementation of innovative approaches to reduce the risks associated with the sedentary lifestyle and hyper nutrition in developed countries should not overshadow the continuing threat from infectious diseases, especially resistant strains or newly encountered agents. Interventions must fit populations and the threats to health they experience, while anticipating changes that will emerge with success in some areas. This will require new ways of thinking that go beyond the epidemiologic transition theory.

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Frailty and Malnutrition: Related and Distinct Syndrome Prevalence and Association among Community-Dwelling Older Adults: Singapore Longitudinal Ageing Studies.

Kai Wei, Shiou Liang Wee, Tze-Pin Ng … (2017)

The association between frailty and malnutrition is widely noted, but the common and distinct aspects of this relationship are not well understood. We investigated the prevalence of prefrailty/frailty and malnutrition/nutritional risk; their overlapping prevalence; compared their sociodemographic, physical, and mental health risk factors; and assessed their association, independently of other risk factors.

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Author and article information

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Rahul Malhotra: (View ORCID Profile)

Journal

Title: The Gerontologist

Publisher: Oxford University Press (OUP)

ISSN (Print): 0016-9013

ISSN (Electronic): 1758-5341

Publication date Created: December 04 2018

Publication date (Electronic): December 04 2018

Affiliations

[1 ]Health Services and Systems Research

[2 ]Centre for Ageing Research and Education, Duke-NUS Medical School

[3 ]Saw Swee Hock School of Public Health, National University of Singapore, Singapore

[4 ]Centre for Sport and Exercise Sciences, University of Malaya, Malaysia

[5 ]Ageing Research Institute for Society and Education, Nanyang Technological University

[6 ]Centre for Research on the Economics of Ageing, Singapore Management University

[7 ]Health Services and Policy Program, Geriatric Education and Research Institute

[8 ]Joint Nanyang Technological University–The University of British Columbia (NTU–UBC) Research Centre of Excellence in Active Living for the Elderly

[9 ]Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital

[10 ]Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore

Article

DOI: 10.1093/geront/gny160

PubMed ID: 30517628

SO-VID: 388ab2b5-c624-4deb-b95b-f1c3206b5db8

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https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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The Aging of a Young Nation: Population Aging in Singapore

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Most cited references 22

Multimorbidity in older adults.

The Epidemiologic Transition: Changing Patterns of Mortality and Population Dynamics.

Frailty and Malnutrition: Related and Distinct Syndrome Prevalence and Association among Community-Dwelling Older Adults: Singapore Longitudinal Ageing Studies.

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