THE SIGNS Study - III & IV

Transitions in Health, Employment, Social Engagement and Inter-Generational Transfers in Singapore Study
(THE SIGNS Study) – III & IV

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 two waves of data collection in THE SIGNS Study. The first wave (THE SIGNS Study – I) was conducted in 2016-2017, and the second wave (THE SIGNS Study – II) was conducted in 2019. Data collection was conducted face-to-face at the residence of the participants. A total of 4549 older adults participated in THE SIGNS Study – I, and 2887 of these individuals also participated in THE SIGNS Study – II.

Now, in 2024-2025, we are collecting data for the third wave of THE SIGNS Study, i.e., THE SIGNS Study – III. 

As of 24 November 2024, 2160 participants have been recruited for THE SIGNS Study - III.

THE SIGNS STUDY - III


Recruitment is currently ongoing for THE SIGNS Study – III. National University of Singapore (NUS) has contracted the Institute of Policy Studies (IPS) Social Lab at NUS to collect data for this study. Invitation letters informing eligible households of their selection for the study will be sent out on a rolling basis through 2024 and 2025. Interviewers from IPS Social Lab will visit eligible households for data collection.

WHO CAN PARTICIPATE IN THE SIGNS STUDY - III?

Participants who meet all the following criteria can join THE SIGNS Study-III:

  • Singapore Citizen or Permanent Resident
  • Aged 60 to 110 years
  • Living at an address provided to CARE by the Department of Statistics, Singapore
  • Not living in an institution, for health or non-health reasons, at the time of the survey

From August 2024 till 2025, we are collecting data for participants who meet the criteria.

If the selected respondent is unable to respond to an initial set of screening questions due to a medical diagnosis of dementia, or does not clear the screening, then a proxy can respond on his or her behalf. This proxy must be a family member or relative of the selected respondent, aged 21 years and above and someone who is familiar with the selected respondent's health and social situation.

WHAT DOES THE SELECTED RESPONDENT
HAVE TO DO?



Initial screening


To determine if the older adult or a proxy respondent should respond to the questionnaire.


(About 10 minutes each)



Documented informed consent

To provide the older adult or proxy respondent with more information about the study, and to document his/her consent for participation in the survey.

(About 10 minutes each)



Interviewer administered questionnaire

The older adult or his/her proxy respondent will answer a survey questionnaire administered by a trained interviewer.

(About 90 minutes each)



Physical measurements

The interviewer will measure the older adult's height, weight, blood pressure, hand grip strength, walking speed, and balance.

(About 30 minutes each)

FREQUENTLY ASKED QUESTIONS (FAQ)

What is the approximate number of research participants involved?

 

Up to 10,000 participants across Singapore are expected to participate in THE SIGNS Study – III.

 

How will my privacy and the confidentiality of my research records be protected?

 

IPS Social Lab (NUS), who was contracted to carry out data collection for this study, will store all information in secured, locked locations, before it is handed over to CARE. All data collected will be kept by CARE in accordance with the NUS Research Data Management Policy. A participant's personal data will never be stored alongside their research data (i.e., responses to the screener, responses to the questionnaire, and data pertaining to the older adult’s physical measurements). Your personal data will never be used in a publication or presentation. All your research data will be coded i.e., only identified with a case number. 

 

Will there be reimbursement for participation?

 

Participants in THE SIGNS Study – III will be reimbursed with cash in appreciation of their time. $40 (cash) will be given if participants respond to the questionnaire only. Alternatively, $50 (cash) will be given if participants respond to the questionnaire and undertake the physical measurements.

 

I have not received an invitation letter for the study. Can I sign up for it?


Individuals or households selected for participation in THE SIGNS Study - III are being sent invitation letters on a rolling basis through 2024 and 2025. You will receive an invitation letter if you or your household is selected, and an interviewer from IPS Social Lab will visit you subsequently.

FINDINGS AND PUBLICATIONS
FROM THE SIGNS STUDY

THE SIGNS Study - I and II Pictogram Findings

Special Reports

THE SIGNS Study I

THE SIGNS Study II

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.2023.02.001
  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 


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?

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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

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STUDY TEAM

CONTACT US

GET IN TOUCH WITH IPS SOCIAL LAB

If you or your household member has been invited to participate in THE SIGNS Study – III, and should you wish to verify the identity of the interviewer, or clarify any matters about the study, or specify a time at which the interviewer should visit you, or opt out from the study, please contact Ms Valerie Neo from IPS Social Lab at:

phone
  • Telephone: 9478 2304 (9am to 5pm, Monday to Friday) 
email
  • Email: ips.soclab.signs@nus.edu.sg

 

GET IN TOUCH WITH THE SIGNS STUDY TEAM AT CARE

If you or your household member has been invited to participate in THE SIGNS Study – III, and should you wish to speak to someone from Duke-NUS Medical School about the 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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