SG90 pinpoints modifiable factors for longevity in SG

The SG90 cohort study fills knowledge gaps in healthy ageing in Singapore by identifying modifiable factors that contribute to longevity in the oldest-old.

“This study offers a comprehensive clinical and biological data resource on healthy ageing among Asia’s oldest-old, laying a foundation for targeted interventions to promote healthy longevity and quality of life (QoL),” the researchers said.

The study included 1,158 participants aged ≥85 years (median age 87 years, 64.5 percent women) from the Singapore Chinese Health Study and Singapore Longitudinal Aging Study between 2015 and 2021. Almost all participants were of Chinese ethnicity (97.5 percent). [Eur J Epidemiol 2025;40:1133-1141]

Most participants were nonsmokers (72.1 percent), never or rarely consumed alcohol (94.9 percent), and reported exercising 2–3 times weekly (66.5 percent).

Functional assessments indicated high independence, with median scores of 20 and 14 for the Barthel Index Basic Activities of Daily Living (ADL) and Lawton and Brody Instrumental ADL, respectively. QoL score was higher in men than women (mean 73.3 vs 70.8).

Approximately a third (36 percent) of participants rated their health as ‘good’ to ‘excellent’, while 25.4 percent rated their health as ‘poor’. A quarter of participants experienced falls in the past 1 year (24.2 percent) and reported having diabetes (24.1 percent) and/or arthritis (24.6 percent).

Hypertension was the most frequent medical condition (76.7 percent; median sitting systolic blood pressure 139.8 mm Hg), followed by hypercholesterolaemia (66 percent).

According to Asian BMI thresholds, most male participants were within the normal weight range (mean weight 58 kg, median BMI 22.4 kg/m²). Conversely, most female participants fell within the overweight category (mean weight 51.8 kg, median BMI 23.4 kg/m²).

Waist circumferences were similar between men and women (mean 87.9 and 87 cm). However, according to the investigators, men fell slightly below the Asian abdominal obesity cutoff, while women exceeded it (≥90 cm for men and ≥80 cm for women).

Physical performance was better in men than women, as reflected by the higher median handgrip strength (22.2 vs 13.5 kg) and Short Physical Performance Battery (7 vs 4) scores in men. “[These] reflect the expected sex differences in muscle strength and functional capacity among older adults,” the researchers said.

Overall, participants had a median Mini-Mental State Examination score of 23 and a median Geriatric Depression Scale-15 score of 3, indicating mild-to-moderate cognitive impairment and minimal depressive symptoms, respectively.

A foundation for guiding future studies

Singapore met the criteria for an ‘aged’ nation in 2021 and is projected to reach the ‘super-aged’ mark by 2030. [https://www.population.gov.sg/files/media-centre/publications/population-in-brief-2021.pdf, accessed January 21, 2026] “A nation or region is considered ‘ageing,’ ‘aged,’ or ‘super-aged’ when the percentage of individuals aged ≥65 years exceeds 7, 14, and 20 percent, respectively,” the researchers explained.

They noted that healthspan (ie, likelihood of living without chronic diseases or disabilities of ageing) has not increased to the same extent as lifespan. [Geroscience 2018;40:361-364] The gap between healthspan and lifespan is increasing and is estimated to be around 9 years. [NPJ Regen Med 2021;6:57] “This is especially relevant to Singapore, as the current gap in Singapore averages around 11 years, which is greater than the global average,” they said.

More years with diseases and disabilities are not only tied to a higher healthcare cost; they also adversely impact QoL. [Mayo Clin Proc Innov Qual Outcomes 2024;8:112-119; Int J Prev Med 2019;10:65]

“The SG90 cohort focuses on an understudied population, the oldest-old in Southeast Asia, which allows for investigation into the determinants of healthy ageing and development of potential interventions to promote longevity and QoL,” the researchers noted.

“[The study identified] a range of modifiable medical, biological, lifestyle, psychological, behavioural, and social factors that may contribute to healthy longevity, thus creating a comprehensive foundation for guiding future intervention studies,” they said.