Gerontology Research Programme: The Singapore Longitudinal Ageing Studies (SLAS I & II)

NCT03405675 | Unknown

• 1 other identifier: NUS-IRB 04-140
• Study Type: observational
• Target: 6,183
• Locations: 1 country
• Sites: 1

Brief Summary

The Gerontology Research Programme (GRP) in the National University Singapore's Department of Psychological Medicine, was formed to coordinate and facilitate the conduct of multi-disciplinary research on in a wide range of research on ageing and health. The establishment of the Singapore Longitudinal Aging Cohort will provide a large community-based cohort of elderly subjects for observational studies with useful clinical applications. Research synergy is achieved in terms of pooling multi-disciplinary expertise, and combining genetic, biological, environmental, behavioural, social, clinical, and health services approaches to gerontological research.

Conditions

Cognitive Changes Due to Organic Disorder (Finding); Dementia; Mild Cognitive Impairment; Frailty; Depression; Healthy Ageing; Biological Ageing

Keywords

Dementia; Mild cognitive impairment; Cognitive abilities and changes; Functional change and disabilities; Depression; Health and social services utilization; Quality of life; Adverse drug effects; Social network and support; Self-rated health; Medical morbidities; Falls; Health risk behaviors; Nutrition; Apo-E lipoprotein; Phytochemicals; B12; Folate; Homocysteine; Lifestyle; Physical activity; Leisure activity; Successful ageing; Mortality

Outcome Measures

Primary Outcomes (5)

• Dementia and Mild Cognitive Impairment (MCI) Subtyping (Clinical diagnosis of different stages of Dementia)

  Dementia and MCI is determined by clinical case conference adjudication where geriatric and psychiatric clinicians convene to determine the diagnosis of a case, utilizing the data from (i) Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) (4-5); (ii) Clinical Dementia rating scale: a 5-point scale used to characterize 6 cognitive and functional domain performance: Memory, Orientation, Judgment \& Problem Solving, Community Affairs, Home \& Hobbies, and Personal Care (6). Information to make each rating is obtained through a semi-structured interview of the patient and a reliable informant (e.g. family member). A higher score indicates increased severity of cognitive impairment; (iii) Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE) - reliable informants report on the cognitive state of the participant (7); (iv) a scale on self-reported subjective cognitive difficulties; and (v) a neuropsychological assessment battery (described below).

  20 years - once every 3-4 years

• Global and specific domain cognitive functioning ability (Measuring of Global and Specific domain of Cognitive functions)

  MMSE (4) and MoCA (5) - 30 items, total scores range from 0-30, higher scores indicate better cognitive functioning. A cut-off of a score of =\<25 is determined as screening positive for cognitive impairment. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) (8) - measures immediate memory, visuospatial ability, language, attention, delayed memory, and a global cognitive functioning score (a summation of domain scores). A neurocognitive battery measures immediate and delayed memory/learning, visuospatial ability, language, attention, and executive functioning. All domains are calculated by weighted averages of age and education adjusted scores. Tests: (i) Digit Span forward and backwards tasks (9); (ii) Rey's Auditory Verbal Learning Test (10); (iii) Story Memory Test (11); (iv) Brief Visuospatial Memory Test - Revised (12); (v) Boston Naming Test (13); (vi) Clock Reading Test; (viii) Colour Trials 1 and 2 (14); (ix) Block Design task (9).

  20 years - once every 3-4 years

• Frailty (Measuring the physical and Cognitive Frailty)

  Physical frailty was assessed by scores (1 = present, 0 = absent) for five components (shrinking, weakness, slowness, exhaustion, and low Physical Activity (PA)) proposed by Fried et al (3), with the following operational modifications: (i) Shrinking was defined by unintentional weight loss of 4 kg or more in the past 6 months, or BMI less than 18.5 kg/m2, or calf circumference of 31 cm or less. (ii) Weakness was assessed by knee extension strength task in kilogram. (iii) Slowness was assessed by a gait speed test (15). (iv) Exhaustion was measured as a summed score of 3 questions (1-5), "Did you have lots of energy/feel tired (reverse-scored, rs)/worn out (rs)?" (16). A score of \<10 was used to denote exhaustion. (v) Low PA was measured by the LASA PA scale, with those falling below the local gender-specific lowest quintile deemed as low PA (17). Participants are categorised by their total scores as robust (score = 0), pre-frail (score = 1-2), and frail (score = 3-5).

  20 years - once every 3-4 years

• Depressive symptoms and diagnosis (Measuring of Depressive symptoms and assessment of stages of Depression)

  Depressive symptoms are assessed by the 15-item version of the Geriatric Depression Scale (GDS), with a higher score indicating higher depressivity (18). A cut-off score of 5 is used as indicating the presence of depression. Additionally, participants are formally diagnosed by a medically trained research fellow for common mood-related psychiatric conditions using the Structured Clinical Interview for DSM Disorders (SCID) of DSM IV-TR (1), such as Major Depressive Disorder, Minor Depression, Dysthmic Disorder, Mania/Hypomania disorder, Anxiety and panic disorder, Obsessive-compulsive disorder, Post traumatic stress disorder, Psychotic disorder, Mood disorder due to a General Medical Condition and Alcohol abuse disorders, if they screen as positive for depression on the GDS.

  20 years - once every 3-4 years

• Successful ageing (Measuring the biological, psycho-social and lifestyle factors associated with Successful Ageing)

  Successful aging is previously defined (25). Briefly, a score of successful ageing reflects the overall and physical health, cognitive, emotional, social well-functioning, including life engagement \& satisfaction. Physical health and functional well-being was defined as a "good/excellent" self-reported health and IADL independence (20). Cognitive well-functioning and emotional wellbeing was denoted by a minimum MMSE score of 26 (4), and a score below 5 on the GDS (≤5) (18). Social functioning and active engagement in life activities was assessed using a validated questionnaire (26) on participation levels in social, recreational, civic activities, voluntary work, employment/business, and domestic activities. Overall positive life satisfaction was determined using the Life Satisfaction Scale that assessed interest in life, happiness, loneliness, and general ease of living (27). Total summed score ranges from 4 to 18, with the lowest decile indicating a positive life satisfaction.

  20 years - once every 3-4 years

Secondary Outcomes (6)

• Self-reported independent functioning (Measuring the BADL and IADL)

  20 years - once every 3-4 years

• Physical performance (Measuring the physical performance tests)

  20 years - once every 3-4 years

• Health services utilization (Measuring cost and frequency of health services utilization)

  20 years - once every 3-4 years

• Quality of life (Measuring the Quality of life SF 12)

  20 years - once every 3-4 years

• Mortality (Measuring the risk factors related to mortality)

  20 years

Study Arms (2)

SLAS 1

The subjects (N=2800) are recruited from all residents aged 55 years and above in Singapore in the areas covered by the South-East Community Development Council: Geylang, Aljunied, MacPherson, Marine Parade and Bedok (SLAS-I).

Other: SLAS 1

SLAS 2

An additional 3200 subjects are recruited from residents in the Bukit Merah and Jurong (SLAS-II).

Other: SLAS 2

Interventions

SLAS 1 OTHER

NA. Observational study, no interventions administered.

SLAS 1

SLAS 2 OTHER

NA. Observational study, no interventions administered.

SLAS 2

Eligibility Criteria

• Age: 55 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

Community-dwelling Elderly (\>55 years old) that are able to self-ambulate and who possess sufficient cognitive capacity for participation. Individuals with severe physical or mental disabilities were excluded.

You may qualify if:

• Ability to self-ambulate
• Adequate cognitive capacity for participation

You may not qualify if:

• \- Individuals with severe physical or mental disabilities were excluded.

Sponsors & Collaborators

• National University of Singapore: lead
• Karolinska Institutet: collaborator
• Tan Tock Seng Hospital: collaborator
• Ng Teng Fong General Hospital: collaborator
• St Luke's Hospital, Singapore: collaborator
• St. Paul's Hospital, Canada: collaborator
• Singapore Institute of Technology: collaborator
• Duke-NUS Graduate Medical School: collaborator
• Melbourne Health: collaborator
• University of California: collaborator
• University Hospital, Basel, Switzerland: collaborator
• Université de Sherbrooke: collaborator
• University Hospital Tuebingen: collaborator
• National University Hospital, Singapore: collaborator
• Khoo Teck Puat Hospital: collaborator
• Shanghai Jiao Tong University School of Medicine: collaborator
• University of British Columbia: collaborator

Study Sites (1)

National University of Singapore

Singapore, 119260, Singapore

Location

Related Publications (28)

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  BACKGROUND

• Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J; MCI Working Group of the European Consortium on Alzheimer's Disease (EADC). Mild cognitive impairment (MCI) in medical practice: a critical review of the concept and new diagnostic procedure. Report of the MCI Working Group of the European Consortium on Alzheimer's Disease. J Neurol Neurosurg Psychiatry. 2006 Jun;77(6):714-8. doi: 10.1136/jnnp.2005.085332. Epub 2006 Mar 20.

  PMID: 16549412 BACKGROUND

• Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, Seeman T, Tracy R, Kop WJ, Burke G, McBurnie MA; Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001 Mar;56(3):M146-56. doi: 10.1093/gerona/56.3.m146.

  PMID: 11253156 BACKGROUND

• Folstein MF, Folstein SE, McHugh PR, Fanjiang G. Mini-Mental State Examination: MMSE user's guide. Psychology Assessment Resources; 2000.

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• Nasreddine ZS, Phillips NA, Bedirian V, Charbonneau S, Whitehead V, Collin I, Cummings JL, Chertkow H. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005 Apr;53(4):695-9. doi: 10.1111/j.1532-5415.2005.53221.x.

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  PMID: 36074716 DERIVED

Biospecimen

Retention: SAMPLES WITH DNA

Biological specimens (blood and urine) will be analyzed for full blood count, lipid panel, liver function test, blood biochemistry, PBMC, DNA, immunological tests (whole blood, serum, plasma).

MeSH Terms

Conditions

Signs and Symptoms; Dementia; Cognitive Dysfunction; Frailty; Depression; Drug-Related Side Effects and Adverse Reactions; Health Risk Behaviors; Motor Activity

Condition Hierarchy (Ancestors)

Pathological Conditions, Signs and Symptoms; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neurocognitive Disorders; Mental Disorders; Cognition Disorders; Pathologic Processes; Behavioral Symptoms; Behavior; Chemically-Induced Disorders; Health Behavior

Study Officials

• Tze Pin Ng, PhD

  National University of Singapore

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professorial Fellow and Research Director

Study Record Dates

• First Submitted: October 26, 2017
• First Posted: January 23, 2018
• Study Start: July 1, 2003
• Primary Completion: December 31, 2020
• Study Completion: December 31, 2020
• Last Updated: March 14, 2019

Record last verified: 2019-03

Locations

SG (1)