Centre for

Research on

Empowering Successful Ageing

Ageing-in-place
 This report is the fourth instalment of a series of annual reports published by the
Centre for Research on Successful Ageing (ROSA). The purpose of this series is to
outline the yearly achievements made by ROSA in the research being conducted
on the well-being of older adults in Singapore.

We would like to thank The Ngee Ann Kongsi for their generous support and
contribution towards ROSA, enabling us to produce this series of reports for
dissemination to the public and key stakeholders.

2 Empowering Ageing-in-place
Contents
Introduction 4

Research Collaborations 5

SkillsFuture Singapore 5

Agency for Integrated Care 6

Geriatric Education and Research Institute 6

Events 7

3rd ROSA Annual Symposium on Successful Ageing 7

2nd Annual SIGMA Research Symposium 8

SMU-DBS Foundation Symposium on Essential Household Needs in Singapore 9

Meet-up Sessions with the Singapore Life Panel ® (SLP) Members 11

Launch of e-Vouchers 12

Research Developments 13

Research on Ageing-in-place 13

Research at ROSA 19

Health and social impacts of an ageing population in Singapore, and why it matters 19

Social engagement, networks, and well-being by gender and marital status 19

Activity participation and well-being 20

Application of causal discovery methodology in social science 21

Looking Ahead at the Coming Year 23

Acknowledgements 25

About the Centre for Research on Successful Ageing (ROSA) 26

Our Supporters 27

Empowering Ageing-in-place 3
Introduction
In the past year, three governmental ministries – the variety of perspectives. Finally, we provide an update of
Ministry of Health, Ministry of National Development, the latest engagements with our Singapore Life Panel
and Ministry of Transport – have jointly led Age Well ® (SLP) members.
SG, a national programme that seeks to support
older Singaporeans in ageing well in their homes In the second section, we share the findings and progress
and their communities. This programme reflects the from our research projects. Recently, our team has
government’s priority in enabling ageing-in-place, leveraged computer science methods in our research.
a trend that has been increasingly welcomed by These methods have enabled us to better understand
older Singaporeans. Current policies that seek to phenomena that are immediately relevant to the well-
enable ageing-in-place are centred on three forms being of older Singaporeans, such as the different
of enhancements in the environments in which older factors causing life satisfaction and social isolation, and
Singaporeans live, such as the implementation of how physical activities and the neighbourhood factors
Active Ageing Centres, strengthening of support for affect well-being. We have also investigated how the
care needs, and improvements to the built environment extent of social engagement differs across subgroups
such as the neighbourhood. Along with these policy of older Singaporeans and how variations in activity
developments, the Centre for Research on Successful participation may have differential implications for
Ageing (ROSA) has been building on existing research their well-being. As our team continues to explore and
on the role of different aspects of the environments apply new methodologies to the rich data in the SLP,
in enabling ageing-in-place, alongside the multitude we hope to leverage the full potential of our datasets
of themes that are central to successful ageing. In and generate key insights that will help us to better
the following sections, the report details the key understand older Singaporeans.
developments in our research, our collaborations with
industry partners, and the events that we have been a We hope that this fourth instalment of our annual report
part of. will provide valuable insights on the ageing landscape
in Singapore. Through our research developments and
In the first section, we present an overview of our partnerships with key stakeholders, we endeavour
institutional developments. First, we provide details of to generate evidence-based insights that can be
our collaborations with key industry partners, including translated into policies and practices that seek to
newly forged ones. Such partnerships are key in the advance the holistic well-being of older Singaporeans.
exploration of emerging research areas that encompass To this end, the members of the SLP – past and present
various aspects of the lives of older Singaporeans. Next, – are an invaluable asset to ROSA and are very much
we showcase the events that we have participated in appreciated by our team. We would like to express our
the past year, both locally and abroad. These events gratitude to The Ngee Ann Kongsi and the Ministry
have served as invaluable opportunities for us to of Education for supporting our vision to advance
showcase our work while learning from others’ and successful ageing in Singapore.
engage in constructive discussions involving a wide

4 Empowering Ageing-in-place
Research Collaborations
SkillsFuture Singapore reskilling opportunities, and if so, where they usually
turn to for these opportunities.
In October 2023, we engaged SkillsFuture Singapore
(SSG) to jointly develop a set of research questions to
We signed a research collaboration agreement (RCA)
capture the perceptions that older adults have towards
with SSG in May 2024 and created a set of 27 questions,
meaningful work, and how they can be encouraged
which measured a range of work-related indicators,
to participate in upskilling / re-skilling. To this end, we
such as current employment status, work-life balance,
sought to explore six research areas: (i) the activities
work meaningfulness, autonomy at work, relationship
and goals that older adults perceive to be important,
with work colleagues, work hours, flexibility of work
(ii) the factors that motivate or discourage older adults
arrangements, reskilling aspirations and opportunities,
from continuing waged work (iii) why and how older
and beliefs regarding work, reskilling and volunteerism.
adults find their work to be meaningful, (iv) the types
We fielded these questions in June 2024, and we hope
of skills that older adults are interested in reskilling
that the findings will support SSG’s efforts in workplace
themselves with, (v) whether older adults are seeking
transformations and reskilling opportunities for older
employment opportunities, and if so, where they do
adults in Singapore.
so; and (vi) whether older adults are looking to enrol in

Empowering Ageing-in-place 5
Research Collaborations

Agency for Integrated Care validate a scale that measures the five dimensions of
intrinsic capacity, which comprises (i) locomotion, (ii)
The Agency for Integrated Care (AIC) continues to sensory function, (iii) vitality, (iv) cognitive function,
be a valued collaborator. In 2023, we co-studied and (v) psychological well-being. The second area
the issues of social isolation and loneliness among examines how intrinsic capacity is associated with
older Singaporeans through a series of focus group everyday functioning in older adults. We will propose
discussions involving members of the SLP. We found and validate the use of the International Classification
that most participants believed that maintaining of Functioning, Disability and Health (ICF) framework,
social connections and active engagement in the which measures the physical health or disability of a
community is an individual responsibility. However, population1, to capture relevant areas of functioning
other participants were also aware of barriers that – including social participation. Finally, we aim to
may hinder social participation (e.g., caregiving build upon previous studies that have established
duties, limitations in physical infrastructures). Some that intrinsic capacity influences social participation
participants suggested that continued employment through disability, by verifying whether the results from
may be a way to allow older adults to be socially and such past studies can be replicated in the Singaporean
mentally engaged, while others pointed to the utility context.
of social media platforms in helping older adults
connect with like-minded individuals. At the end of the
discussions, we consolidated our findings in a report
that was presented to the AIC.

In the next phase of our collaboration, we aim to

investigate the various caregiving arrangements of
older Singaporeans, including their care preferences
and needs, as well as the well-being of caregivers.

Geriatric Education and Research

Institute
In December 2021, we began collaborating with the
Geriatric Education and Research Institute (GERI),
with the aim of examining the intrinsic capacity among
older Singaporeans. Intrinsic capacity is an important
indicator for successful ageing, as it looks at an
individual’s physical and mental capabilities. Declines
in intrinsic capacity may foreshadow limitations in
self-care and social participation and are therefore
important to track longitudinally.

In this collaboration, there are three areas of focus.

The first area involves the construction of an intrinsic
capacity scale. Building upon the World Health
Organisation’s (WHO) framework for healthy ageing (i.e.,
meeting basic needs, learning and decision-making, 1
World Health Organization, ‘International Classification of Functioning, Disability and Health
(ICF)’, n.d., https://www.who.int/standards/classifications/international-classification-of-
mobility, relationships, and social contribution), we will functioning-disability-and-health.

6 Empowering Ageing-in-place
Events
3rd ROSA Annual Symposium on In the first segment, esteemed researchers in the field
of ageing – such as Professor Ursula Staudinger from
Successful Ageing Technische Universität Dresden and Professor Tughrul
Arslan from the University of Edinburgh – gathered
in a panel discussion to provide their expertise
and experience on how Singapore can support the
formation of better physical infrastructures that would
be suitable for older adults to age in place comfortably.
In the second segment, scholars and practitioners –
such as Professor Takashi Oshio from the Hitotsubashi
University and Dr Gog Soon Joo from SkillsFuture
Singapore – also shared about the benefits that older
employees can bring to the workplace and how society
can better support these individuals. Finally, the
symposium also highlighted the importance of ground-
up translational research projects, such as Project
Silverlight, and how they can bridge the gap between
L-R: Prof Lily Kong, President, SMU; Mr Ong Ye Kung, Minister for
Health; Mr Lie Kee Pong, Vice President of The Ngee Ann Kongsi; academia and policy / practice to combat issues
and Prof Paulin Straughan, Director, ROSA. pertaining to ageing.

On 12 October 2023, we held the 3rd Annual ROSA

Symposium on Successful Ageing, which was attended
by over 300 participants. The event was graced by our
Guest of Honour, Mr Ong Ye Kung, Minister for Health.
The symposium revolved around themes such as the
importance of the physical environment in supporting
ageing-in-place, and how the current working
landscape can be transformed to better accommodate
older employees.

L-R: Prof Takashi Oshio, Hitotsubashi University; Asst Prof Joelle

Fong, National University of Singapore; Prof Paulin Straughan,
Director, ROSA; Asst Prof Xuan Zhang, SMU; and Dr Gog Soon Joo,
Chief Skills Officer, SkillsFuture Singapore.

L-R: Assoc Prof William Tov, Deputy Director, ROSA; Prof Ursula
Staudinger, Rector, Technische Universität Dresden; Asst Prof Tan
Shin Bin, National University of Singapore; and Dr Wan Chen K
Graham, Deputy Director (Research), Agency for Integrated Care.

Empowering Ageing-in-place 7
Events

2nd Annual SIGMA Research Symposium

Participants of the 2nd Annual SIGMA Research Symposium. In picture: Prof Timothy Clark, Provost, SMU (1st row, 5th from right); Prof Paulin
Straughan (1st row, 2nd from right)

The Societal Impact and Global Management Alliance showed that by providing older adults with the agency
(SIGMA) is a global network of universities that have to organise ground-up events with some assistance
pledged to develop closer interdisciplinary research from student volunteers, these individuals experienced
collaborations. As SMU is a key collaborating institution improved social engagement and well-being and
within SIGMA, ROSA was invited to share about its fostered improved intergenerational relationships.
academic contributions at the 2nd Annual SIGMA They concluded their segment by explaining how the
Research Symposium. The conference was held in success of Project Silverlight is crucial in bridging the
Beijing, China, from 23 to 24 May 2024, in conjunction gap between academia and policy / practice.
with the 20th International Conference on Pensions,
Insurance and Savings. Second, Dr Tan Yi Wen, Research Fellow at ROSA,
shared in a panel discussion session about his paper
Our team presented on a variety of research topics at the on the determinants of social isolation among older
conference. First, Professor Paulin Straughan, Director adults. By utilising causal discovery – a computer
of ROSA, and Ms Lim Wensi, Centre Manager of ROSA, science method – Dr Tan and his team was able to
shared about Project Silverlight, a ground-up social identify the factors that most likely influenced the level
initiative that empowered older adults to design and of social isolation among older Singaporeans. From
lead social engagement initiatives. Their presentation the results, he found that feeling a sense of meaning in

8 Empowering Ageing-in-place
 Events

life leads to the perception of the self as being helpful, the intricate, gendered linkages between spouses’
which leads to decreased feelings of social isolation. social participation and subjective well-being.
Thus, he recommended that besides enhancing one’s
sense of meaning in life, interventions can also look Importantly, apart from the showcase of our research,
for ways to make older adults feel helpful, such as by participating at the symposium enabled our team to
encouraging them to partake in volunteerism, to lessen network with key ageing researchers such as Professor
social isolation among these individuals. Zhao Yaohui from Wuhan University, who leads the
China Health and Retirement Longitudinal Study
Meanwhile, Associate Professor William Tov, Deputy (CHARLS). We also further engaged with various legal
Director of ROSA, presented his research on the experts to explore the topic of retirement using legal
stability of life satisfaction. The main purpose of Assoc and economic frameworks.
Prof Tov’s study was to assess how much of a person’s
life satisfaction is stable versus changeable. Using an
advanced statistical analysis called STARTS (Stable
Trait--Auto-regressive Trait--State) modeling, Assoc
Prof Tov discovered that life satisfaction is largely
stable in the short term, such as within a year, but is
more influenced by slower changing factors in the
long term, such as within six years. He concluded the
presentation by suggesting that the evaluation period
of a policy should extend beyond just a single year after
it has been enacted, to observe and test the effects
of policies on a population’s life satisfaction more Prof Paulin Straughan participating in a Questions & Answers
effectively. segment with one of the speakers.

Finally, Assistant Professor Cheng Cheng, a SMU-DBS Foundation Symposium

Collaborator with ROSA, showcased her study which on Essential Household Needs in
examined spousal differences in activity levels and
Singapore
engagement. As prior literature has rarely considered
how a spouse’s social participation may affect
one’s own well-being and how the nature of social
participation is often gendered, Asst Prof Cheng
sought to use a dyadic approach to examine how the
relative social participation between spouses affects
later-life life satisfaction among heterosexual couples
in the United States. Using dyadic data from the Health
and Retirement Study (HRS) 2008–2018, Asst Prof
Cheng reported that (i) formal and informal social
participation has a stronger impact on husbands’ life
satisfaction than on wives’, (ii) wives’ formal social
participation has a positive spillover effect on their
husbands’ life satisfaction, and that (iii) spousal
L-R: Asst Prof Nathan Peng; Dr Tan Ern Ser; Prof Paulin Straughan;
disparities in informal social participation negatively Prof Lily Kong; Mr Masagos Zulkifli; Prof Takashi Oshio; Dr Mathew
Mathews; Ms Joyz Tan Dunlin; Mr Mohamed Fareez Bin Mohamed
affect husbands’ life satisfaction. She concluded her Fahmy; and Ms Monica Datta.
presentation by highlighting how these results illustrate

Empowering Ageing-in-place 9
Events

The SMU-DBS Foundation Symposium on Essential Professor Takashi Oshio from the Institute of Economic
Household Needs in Singapore took place on 12 July Research, Hitotsubashi University, and Professor
2024 at The Ngee Ann Kongsi Auditorium at SMU. Aya Abe, Director of the Research Center for Child
Our Guest of Honour, Mr Masagos Zulkifli, Minister and Adolescent Poverty at the Tokyo Metropolitan
for Social and Family Development, graced the half- University, presented their studies on relative
day event and concluded it with a closing speech. deprivation and essential needs in Japan. The second
The symposium aimed to promote greater public segment was opened by Dr Mathew Mathews, Principal
awareness on the topics of essential household needs, Research Fellow and Head of the Social Lab at the IPS,
relative deprivation, and poverty. Two studies that who presented findings from the Public Perceptions
were supported by the Ministry of Social and Family of Provision of Essential Needs study. Dr Mathews
Development (MSF) were presented in the symposium, summarised that while most Singaporeans believed
titled the Household Needs Study (HNS) and the Public that they should be self-reliant, they also believed that
Perceptions of Provision of Essential Needs study, the government should still be responsible for providing
respectively. Conducted by SMU, the HNS investigated essential healthcare needs.
a wide range of items that Singaporeans – from
varying demographics – deemed a necessity, their The scholars, as well as practitioners from corporations
ability to afford these items, and their general beliefs and social service sectors, such as Ms Joyz Tan Dunlin
and attitudes towards poverty. The other study – the from Fei Yue Family Service Centre, Mr Mohamed
Public Perceptions of Provision of Essential Needs Fareez Bin Mohamed Fahmy from Allkin Singapore, and
study – conducted by the Institute of Policy Studies Ms Monica Datta from the DBS Foundation, were then
(IPS) sought to examine who Singaporeans believe engaged in two panel discussions moderated by Asst
should be responsible for providing for those who are Prof Nathan Peng at SMU and Dr Tan Ern Ser, Adjunct
unable to afford basic necessities. In total, over 220 Principal Research Fellow and Academic Adviser at the
participants – comprising individuals from government IPS. These discussions covered themes such as the
agencies, SMU, and corporate and social services rapidly changing perceptions of what essential needs
sectors – attended the symposium. are, the societal barriers preventing the lower income
from receiving assistance, and how social services and
corporations can partner with one another to empower
those with lower income.

L-R: Prof Paulin Straughan; Prof Takashi Oshio; and Asst Prof
Nathan Peng.

Prof Paulin Straughan shared key findings from the L-R: Dr Mathew Mathews; Mr Mohamed Fareez Bin Mohamed
Fahmy; Ms Joyz Tan Dunlin; Ms Monica Datta; and Dr Tan Ern Ser.
HNS and explained that although there was consensus
among Singaporeans on which items are deemed a
necessity, there were certain demographic differences
regarding these perceptions. Following this, both

10 Empowering Ageing-in-place
 Events

Meet-up Sessions with the Singapore Life Panel ® (SLP) Members

A group photo with our SLP members and our team during the meet-up session held in June 2024.

A total of 15 SLP meet-up sessions were conducted initiatives like Healthier SG can be better marketed to
from January 2023 to August 2024, with each provide adequate support for the older demographic,
session consisting about ten SLP members. During as some of them may be reluctant to enrol in certain
these sessions, we discussed a variety of topics schemes because they may not be fully aware of the
that are relevant to ageing in Singapore, such as our mechanism or enrolment process of these initiatives.
participants’ opinions on government initiatives, such Overall, the SLP meet-up sessions have provided our
as the Healthier SG and Healthy 365 schemes, how team with invaluable information on the current needs
to age in place successfully, the rising cost of living, of older Singaporeans, as well as new potential areas of
volunteerism, and keeping mentally and physically research.
active during one’s twilight years.

Through these meet-up sessions, we found that

most participants displayed a high sense of self-
responsibility in maintaining their physical, mental, and
social well-being, with many of them taking the initiative
to seek enrichment activities and social engagement
within their communities. In terms of government
initiatives like the Healthy 365 programme, many
participants have been enrolled in them and articulated
its effectiveness and helpfulness in managing their
health and well-being. However, our participants also
noted that not everyone may be able to access these A group photo with our SLP members and Prof Paulin Straughan
during the meet-up session held in August 2024.
resources. They further explained that government

Empowering Ageing-in-place 11
Events

Launch of e-Vouchers
In April 2024, we introduced the option for SLP respondents to receive their vouchers digitally via a weblink provided
by a text message sent to their mobile phones. The e-vouchers are provided using the RedeemSG voucher system
which is also used for nationwide campaigns such as the Community Development Council (CDC) Vouchers Scheme.

As technology continues to advance, embracing digital transformation can offer numerous benefits to ROSA and
the respondents. By adopting e-vouchers, we can streamline processes, enhance convenience, and improve overall
efficiency. One key benefit that sets the e-vouchers apart from the physical vouchers is that respondents who opt
for e-vouchers can enjoy increased flexibility of voucher usage at seven participating merchants.

As of May 2024, 5,550 respondents (69.59%) have opted to switch to e-vouchers, while 2,429 respondents
(30.41%) had opted to continue receiving physical vouchers. Among the respondents who had not made the switch
to e-vouchers, we found that a common reason for not opting for e-vouchers was that they did not have a mobile
data plan (35.52%).

We have designed a comprehensive user guide for the respondents to adopt the e-vouchers. The guide includes
videos that demonstrate how users can navigate the self-checkout counters at the seven participating supermarkets.
In addition, we conducted three outreach sessions in-person and online to address queries or concerns on the usage
of the e-vouchers.

Through the outreach sessions, we received feedback from the respondents on their experience with the
RedeemSG e-vouchers. One common issue that we addressed was the difficulty in accessing the e-vouchers for
respondents who did not have a mobile data plan subscription. To address this issue, we advised respondents to
access the e-vouchers using their Wi-Fi connection at home, screenshot the respective QR codes, and present
them at the supermarket – a method which our team had tested. We also guided the respondents on identifying and
authenticating the e-vouchers on their devices to guard themselves against scam attempts.

We will continue to extend our support to our SLP members through multiple channels to ensure a smooth transition
and to encourage greater uptake of e-vouchers.

Proportion of SLP respondents

who opted for e-vouchers

Physical
Vouchers e-Vouchers

30.41% 69.59%
2,429

5,559

12 Empowering Ageing-in-place
Research Developments

Research on Ageing-in-place
Ageing-in-place is a concept that involves allowing older adults to live independently, safely, and comfortably in their
chosen environment. Recent literature has highlighted the role of technology and healthcare assistance in enabling
older adults to age in place. In Singapore, current policies have emphasised providing technological assistance and
healthcare services to support the needs of older adults. At the individual level, these include home modification
programmes and healthcare device subsidies. At the community level, the integration of older adults’ homes and
caregiving resources into local neighbourhoods, alongside community-based services, help to foster a sense of
rootedness and attachment. To further boost older adults’ sense of attachment to their communities, policies such
as the introduction of Community Care Apartments (CCAs) and the Live Well, Age Well programme play important
roles in enabling ageing-in-place. Moving forward, we plan to examine ageing-in-place through the lens of some of
these policies.

The following section provides a summary of the literature on ageing-in-place, including its definition, prevalent
themes, importance for the holistic well-being of older adults, and Singapore’s approach in empowering and
supporting older adults to age in place.

Empowering Ageing-in-place 13
Research Developments

Literature review
Definition of ageing-in-place
Ageing-in-place refers to the ability of older adults to live independently, safely, and comfortably in their chosen
environment2. It is linked to healthy ageing through the interaction between individuals and the built and social
environments in which they live. For instance, the place attachment theory and the human ecological model highlight
the intricate connections between individuals and their environments. Both theories emphasise the importance of
emotional, psychological, and environmental factors in the context of ageing-in-place3. More recent interpretations,
however, recognise ageing-in-place as a complex interactional phenomenon requiring continuous adjustments to
environmental resources with personal demands. Therefore, older adults are seen as active agents in shaping their
environments, making ageing-in-place a proactive decision rather than a passive strategy.

Cristina Bosch-Farré et al., ‘Healthy Ageing in Place: Enablers and Barriers from the Perspective of the Elderly. A Qualitative Study’, International Journal of Environmental Research and Public
2

Health 17, no. 18 (4 September 2020): 6451, https://doi.org/10.3390/ijerph17186451.

3
Setha M. Low and Irwin Altman, ‘Place Attachment’, in Place Attachment, ed. Irwin Altman and Setha M. Low (Boston, MA: Springer US, 1992), 1–12, https://doi.org/10.1007/978-1-4684-8753-
4_1.

14 Empowering Ageing-in-place
 Research Developments

In the following infographic, we highlight themes that have emerged in the discourse on ageing-in-place.

Themes in Place integration

Ageing-in-place Age-friendly cities promote active ageing and community

participation by supporting physical activity and social
engagement among older adults [3]. For instance, neighbourhood
centres that encourage social interactions have been found to
Built environment reduce depression [4]. Some scholars have suggested involving
older adults in the development of age-friendly housing projects
The built environment plays a crucial role in ageing-in-place by
[5]. While the dynamic concepts of home and neighbourhoods
providing local amenities, accessible public transport, green
change over time due to social and physical factors, it nonetheless
spaces, and safe, walkable neighbourhoods, which enhance
highlights the meaningful connections between place and the
mobility and well-being of older adults [1]. Smart cities and well-
individual. Older adults’ feelings of attachment are not restricted
maintained public spaces foster active and healthy ageing [2].
to a particular place, but the meaning behind those places takes
Urban spaces that are cohesive and promote place identity can
precedence.
support older adults in adapting to changes and maintaining
independence and quality of life. Appropriate infrastructure is
needed to support formal and informal care. Additionally, home Technology
designing programmes that prevent falls and assist mobility are
Technology may be leveraged to support older adults to age in
important enablers for older adults to age in place.
place, particularly in the form of independent living. For example,
home-based devices provide older adults with entertainment,
Social networks companionship, reminders, and emergency functions. However,
low digital literacy may hinder some from adopting these
Social networks are a source of support for older adults ageing-in-
technologies [7], though those who have successfully used them
place [6]. Yet, these networks can be unstable due to factors like
report benefits like an increase in their sense of security [8].
death and separation from family. Opportunities for community
These highlight the potential of social support from family, friends
engagement, including grassroots efforts, are therefore important
or volunteers in helping older adults navigate technology use, a
factors for older adults to age in place. Social connectivity not
potential area for future research.
only fosters community engagement and well-being, but also
integration, familiarity, and a sense of security. This instills a sense
of cohesion, coherence, and continuity between their lives and Individual characteristics
their places of residence.
This theme explores how older adults perceive their community
and their ability to live independently. Psychological traits like
resilience and self-efficacy play a part in motivating older adults
to age in place. It is crucial to acknowledge that older adults are a
heterogeneous group and experience ageing-in-place differently.
From a policymaking perspective, there are no one-size-fits-all
solutions. Moreover, there is a need to conceptualise ageing-in-
place as an active choice, rather than a passive strategy. These are
important considerations - in theory and practice - in supporting
older adults to proactively adapt their environments to suit their
individual needs.

[1] Monica Gripko and Anjali Joseph, ‘The Role of the Built Environment in Supporting
Older Adults’ Engagement: A Narrative Literature Review’, HERD: Health Environments
Research & Design Journal, 13 May 2024, 19375867241250320, https://doi.
org/10.1177/19375867241250320.
[5] Zsuzsu K. C. T. Tavy et al., ‘The Participation of Older People in the Development
[2] Hannah R. Marston and Joost Van Hoof, “Who Doesn’t Think about Technology When of Group Housing in The Netherlands: A Study on the Involvement of Residents from
Designing Urban Environments for Older People?” A Case Study Approach to a Proposed Organisational and End-User Perspectives’, Buildings 12, no. 3 (17 March 2022): 367, https://
Extension of the WHO’s Age-Friendly Cities Model’, International Journal of Environmental doi.org/10.3390/buildings12030367.
Research and Public Health 16, no. 19 (20 September 2019): 3525, https://doi.org/10.3390/
ijerph16193525. [6] Willeke H. Vos et al., ‘Exploring the Impact of Social Network Change: Experiences of
Older Adults Ageing in Place’, Health & Social Care in the Community 28, no. 1 (January
[3] Adithi Moogoor, Spela Monik, and Belinda Yuen, ‘Neighbourhood Environmental 2020): 116-26, https://doi.org/10.1111/hsc.12846,
Influences on Older Adults’ Physical Activities and Social Participation in Singapore: A
Photovoice Study’, Social Science & Medicine 310 (October 2022): 115288, https://doi. [7] Shengzhi Wang et al, ‘Technology to Support Aging in Place: Older Adults’ Perspectives’,
org/10.1016/j.socscimed.2022.115288. Healthcare 7, no. 2 (10 April 2019): 60, https://doi.org/10.3390/healthcare7020060.

[4] Jia Miao, Xiaogang Wu, and Xiulin Sun, ‘Neighborhood, Social Cohesion, and the Elderly’s [8] J. Van Hoof et al., ‘Ageing-in-Place with the Use of Ambient Intelligence Technology:
Depression in Shanghai”, Social Science & Medicine 229 (May 2019): 134-43, https://doi. Perspectives of Older Users’, International Journal of Medical Informatics 80, no. 5 (May
org/10.1016/j.socscimed.2018.08.022. 2011): 310-31, https://doi.org/10.1016/j.ijmedinf.2011.02.010.

Empowering Ageing-in-place 15
Research Developments

Ageing-in-place and well-being

Social well-being. Given that the concept of ageing-in-place is strongly related to social connectedness, its
relationship with social isolation and loneliness becomes apparent. As part of the process of ageing-in-place, older
adults’ experience of social cohesion and social capital plays a role in providing essential social support networks
that help to counter feelings of social isolation. Furthermore, given the strong narrative of technology use in ageing-
in-place, the use of communicative tools is valuable in buffering the risk of social isolation4. The subjective well-
being of older adults is also related to their neighbourhood satisfaction5, which ties in with the importance of how
the built environment supports overall well-being.

Economic well-being. The economic aspects of ageing-in-place also play a critical role in determining the quality
of life and independence of older adults. Those from lower socioeconomic backgrounds may experience financial
strain of living independently, and this has been found to be associated with poorer mental health and overall well-
being6. These highlight the intersection of economic well-being and overall health, where innovative solutions like
reverse mortgages offer a means for “asset-rich and cash-poor” older adults to access their home equity, thereby
enhancing their ability to age in place without compromising their financial stability7. These economic strategies are
essential for supporting the mental and physical health of older adults as they navigate the complexities of ageing-
in-place.
Ageing-in-place in Singapore
Ageing-in-place has been found to be an increasingly popular option for older adults in Singapore, with 85.9% of
them showing a preference to age in place in their own communities in 2018 – a 5.7% increase from the figure in
20138. Ageing-in-place enhances autonomy, fosters independence, and increases community engagement among
older adults9, which leads to improved physical and social well-being10. On a larger scale, promoting ageing-in-place
reduces the need for expensive eldercare institutions, allowing governments to allocate resources efficiently in
other areas, potentially boosting economic growth11. Therefore, it is important for scholars and policymakers to
understand how ageing-in-place can be successfully cultivated in Singapore.

The Singapore government has enacted several policies to promote ageing-in-place. For instance, the Housing
and Development Board (HDB) offers schemes such as the Enhancement for Active Seniors (EASE) programme,
which provides subsidies for older adults to select assistive home modifications (e.g., wheelchair ramps or anti-fall
technology)12. The establishment of Community Care Apartments (CCAs) is another initiative that integrates older
adults’ homes and caregiving resources directly into their local neighbourhoods13. Additionally, several other policies
allow older adults to access a variety of communal healthcare or lifestyle-related resources. For instance, the AIC
has curated the Seniors’ Mobility and Enabling Fund (SMF) to ensure that older adults with physical disabilities have
equal access to assistive healthcare devices at a subsidised rate14. To promote active ageing in the community,
the People’s Association (PA) and Health Promotion Board (HPB) jointly launched the recent Live Well, Age Well
programme to provide various free communal activity sessions or mental wellness workshops to older adults15.

4
Maria Gabriella Melchiorre et al., ‘Social Networks, Use of Communication Technology, and Loneliness of Frail Older People Ageing in Place in Italy: The Impact of the COVID-19 Pandemic’,
Sustainability 15, no. 20 (19 October 2023): 15073, https://doi.org/10.3390/su152015073.
5
Rachel Wen Yi Ngu, Micah Tan, and William Tov, ‘Neighbourhood Satisfaction and Networks Among Older Adults in Singapore’, ROSA Research Brief Series, ROSA Research Brief Series
(Centre for Research on Successful Ageing (ROSA), August 2023), https://rosa.smu.edu.sg/sites/rosa.smu.edu.sg/files/Briefs/May%20Jun23/ Neighbourhood%20Satisfaction%20%26%20
Networks%20Among%20Older%20Adults%20in%20Singapore.pdf.
6
Maree Petersen and Tammy Aplin, ‘Exploring Older Tenants’ Healthy Ageing in Privately Rented Homes’, Australian Social Work 76, no. 1 (2 January 2023): 100–112, https://doi.org/10.1080/0
312407X.2021.1970783.
7
Joelle H. Fong, Olivia S. Mitchell, and Benedict S. K. Koh, ‘Asset-Rich and Cash-Poor: Which Older Adults Value Reverse Mortgages?’, Ageing and Society 43, no. 5 (May 2023): 1104–21, https://
doi.org/10.1017/S0144686X21001045.
8
‘Enabling Ageing in Place’, in Healthy Ageing in Singapore, by Sabrina Ching Yuen Luk (Singapore: Springer Nature Singapore, 2023), 147–83, https://doi.org/10.1007/978-981-99-0872-1_6.

16 Empowering Ageing-in-place
 Research Developments

Understanding emerging care trends in Singapore

As more older adults strive to age in place, it is important to understand emerging care trends in the community. To
that end, we have collaborated with the AIC to explore care-related issues among older Singaporeans. Leveraging
data from the SLP (n = 6,747), we examined their perceptions towards caregiving services and private assisted
living facilities. We present an overview of our findings in the following sections.
Caregiving services
We sought to understand how older Singaporeans think that caregiving services for the self should be funded.
According to the responses provided by the SLP respondents, we found that most of them perceived that caregiving
services for the self should be funded by (i) CPF payouts, (ii) personal savings, and (iii) government assistance.

Private assisted living facilities Interest towards living in a private

We further sought to explore older Singaporeans’ assisted living facility
interests towards living in private assisted living
facilities (e.g., nursing homes) and the characteristics Did not know Not interested
at all
which they perceived to be necessary in these facilities.
14.81%
20.71%
First, we found that the SLP respondents expressed Very
Interested 6.17% Not
varying levels of interest in living in a private assisted 31.31% Interested
living facility. We found that more than one in four
27.00%
respondents expressed that they were interested / very
Interested
interested in living in a private assisted living facility.

9
J. L. Wiles et al., ‘The Meaning of “Aging in Place” to Older People’, The Gerontologist 52, no. 3 (1 June 2012): 357–66, https://doi.org/10.1093/geront/gnr098.
10
Maggie Ratnayake et al., ‘Aging in Place’:, Delaware Journal of Public Health 8, no. 3 (August 2022): 28–31, https://doi.org/10.32481/djph.2022.08.007.
Barbara Horner and Duncan P Boldy, ‘The Benefit and Burden of “Ageing-in-Place” in an Aged Care Community’, Australian Health Review 32, no. 2 (2008): 356, https://doi.org/10.1071/
11

AH080356.
12
Housing Development Board, ‘Enhancement for Active Seniors (EASE)’, 16 July 2024, https://www.hdb.gov.sg/residential/living-in-an-hdb-flat/for-our-seniors/ease.
13
Housing Development Board, ‘Community Care Apartments’, 13 June 2024, https://www.hdb.gov.sg/residential/buying-a-flat/finding-a-flat/types-of-flats/community-care-apartments.
14
Agency for Integrated Care, ‘Seniors’ Mobility and Enabling Fund (SMF)’, n.d., https://www.aic.sg/financial-assistance/seniors-mobility-and-enabling-fund-smf/.
Joyce Teo, ‘Action Plan to Help Older Singaporeans Live Well as They Age and Work Longer’, The Straits Times, 30 January 2023, https://www.straitstimes.com/singapore/health/national-plan-
15

to-help-older-singaporeans-live-well-as-they-age-and-work-longer.

Empowering Ageing-in-place 17
Research Developments

Second, we delved into the reasons that the SLP respondents provided for their interests or disinterests in living in
a private assisted living facility. In terms of their interests in doing so, we found that the top three reasons were as
follows:

On the other hand, the top three reasons for not being interested in living in a private assisted living facility were as
follows:

Third, we identified several characteristics that SLP respondents perceived to be necessary in private assisted
living facilities. The top three characteristics were (i) the provision of care services, (ii) non-medical care services,
and (iii) having sufficient length of lease to last.

Proportion of SLP respondents selecting each characteristic as necessary for private assisted living facilities.

18 Empowering Ageing-in-place
 Research Developments

Research at ROSA

Health and social impacts of an ageing population in Singapore, and why it matters
This essay examines the health and social implications of an ageing population in Singapore.
Using data from the SLP, we explored health and health expenditure profiles of Singaporean older adults. The
trends below highlight the need for healthcare system reforms to manage chronic diseases, rising healthcare
demand, and economic sustainability.
The proportion of Singaporeans who experienced co-morbidity or multimorbidity increases with age.
Singaporeans who experienced a greater number of chronic conditions spent, on average, more on healthcare.
These trends illustrate that more Singaporeans are expected to experience poor health, thereby prompting
the need for reforms in the healthcare system to address chronic diseases, increased demand for healthcare,
and the economic sustainability of the healthcare system.
The social implications of an ageing population include an increasing population of older adults who lived alone
from 2016 to 2023, and who experience poorer subjective health and lower levels of life satisfaction on average.
Thus, there is a need to identify social, psychological, economic, and lifestyle factors that will minimise the gap
between life expectancy (LE) and health-adjusted life expectancy (HALE), as well as to leverage older adults as
assets by empowering them with the agency to contribute to their communities.

You may scan the

following QR code to
access the essay:

Social engagement, networks, and well-being by gender and marital status

Against the backdrop of demographic transitions and a rapidly ageing population in Singapore, this paper explores
the patterns and trends of social engagement along marital status and gender lines, as well as its associations
with social network resources and well-being indicators.
Overall, single men fared significantly worse on social engagement scores, social network size and strength,
social support, overall life satisfaction, physical health satisfaction, mental health satisfaction, economic situation
satisfaction, social well-being scores, feelings of social isolation and perceived helpfulness, as compared to
married men and women and single women. This highlights the need for community programmes to better
engage men, especially single men, in social activities.
While single women fared significantly worse than married older adults on emotional and instrumental support
received, they were more likely to have larger close network sizes, where a greater proportion of single women
reported having greater numbers of close relatives and close friends as compared to the other groups. This
suggests that single women are more adept at actively engaging with and maintaining their close social networks
as opposed to single men.

Empowering Ageing-in-place 19
Research Developments

As Singapore heads towards becoming a super-aged society, there needs to be a shift towards innovative
social engagement models that can position older adults as positive assets of society and drivers of community
programmes, thereby increasing their sense of helpfulness, which has been suggested to reduce social isolation,
and bringing their community engagement to the next level.

You may scan the

following QR code to
access the research
brief:

Activity participation and well-being

Active engagement in life is an important aspect of successful ageing. In this study, we explored patterns of
activity participation among older Singaporeans and how these may be related to their well-being.
We found three types of activity participation among respondents, namely, those who were (i) generally active; (ii)
digitally and physically active, and (iii) digitally active. The table below lists the activities that the respondents in
each group were more likely to participate frequently in.

9.93% 47.57% 42.51%

of respondents of respondents of respondents

Group 1 Group 2 Group 3

Generally active Digitally and physically active Digitally active
Visiting family and friends Hobbies Physical activities Digital contact
Religious activities Volunteering Spending time outdoors
Group activities Spending time outdoors Digital contact
Physical activities Digital contact

A classification of the activities that each group of respondents were likely to participate more frequently.

Further, we found that respondents belonging to Groups 1 (generally active) or 2 (physically and digitally active)
were significantly more likely to experience greater life satisfaction than those in Group 3 (digitally active). In
addition, the likelihood of respondents in Group 1 experiencing greater life satisfaction was greater than those in
Group 2, relative to those in Group 3.
These findings suggest that the breadth of activity participation may be a contributing factor in the well-being
of older adults. Specifically, those who participate frequently in a broader range of activities were more likely to
experience higher levels of well-being than those who do so in a narrower range of activities.
This research concurs with the notion of remaining active in the community as one ages, as highlighted in the
2023 Action Plan for Successful Ageing. Indeed, ageing actively would include keeping up with regular physical
activities, being socially integrated in one’s social circles and the wider community and staying digitally connected,
among many others. As Singapore receives a super-aged population, active engagement will remain key towards
successful ageing.

20 Empowering Ageing-in-place
 Research Developments

Application of causal discovery methodology in social science

Computational social science is an interdisciplinary field where computer science methodologies are used to pursue
social science research. We have recently begun to explore the use of causal discovery, a computer science method
that uses data and input from experts in a specific field to examine the relationship between variables, where causal
relationships are inferred using the software TETRAD. This method allows researchers to identify how changes
in one variable directly or indirectly affects another. This exploratory method provides some preliminary insights
and future potential for utilising computer science methodologies in social science research. In this section, we
showcase two studies that utilised causal discovery to derive insights from our expansive datasets.

Determinants of life satisfaction

This study sought to identify potential causal effects of economic and lifestyle factors on life satisfaction.
The results revealed the following factors as the strongest contributors to life satisfaction: economic situation
satisfaction, satisfaction with daily activities, sense of purpose and meaning, and health conditions.

A causal graph that shows the relationships between economic and lifestyle factors and life satisfaction.

You may scan the

following QR code to
access the research
brief:

Empowering Ageing-in-place 21
Research Developments

Determinants of social isolation

This study explored the potential determinants of social isolation, a prevalent phenomenon among older adults
in Singapore.
The results suggest the following:
A sense of helpfulness is likely to reduce social isolation.
A sense of meaning in life contributes directly to a sense of helpfulness, which, in turn, forms a direct causal link
to social isolation.
Perceived isolation and loneliness may be distinct concepts, with loneliness being more likely to precede social
isolation.
Thus, increasing a sense of helpfulness of older adults, such as promoting volunteerism, may be a potential
strategy to diminish social isolation and advance well-being.

A causal graph that shows the relationships between various indicators of well-being and social isolation.

You may scan the

following QR code to
access the research
brief:

22 Empowering Ageing-in-place
Looking Ahead at the Coming Year

We are extremely grateful to the SLP, stakeholders, collaborators and researchers who have worked with us on
advancing our collective knowledge of the holistic well-being of older adults in Singapore. In the new year, we have
identified several areas of focus and look forward to leveraging our Centre’s data and research capabilities for
societal and policy impact.

Empowering Ageing-in-place 23
Looking Ahead at the Coming Year

SLP Sample Refresh

The SLP is a valuable and representative sample of the older cohorts in Singapore. We will commence a second
panel refresh from August 2024 to January 2025 to recruit 2,000 respondents aged 48 to 53 years (inclusive) to
maintain the representativeness of the SLP and provide a voice to the ‘Young Seniors’ group. We envision that we
can uncover key challenges that this cohort faces, such as caring for the young and old, reskilling and retraining to
meet new job demands and resources such as social networks and financial literacy skills that can be developed to
maintain or boost well-being.

International collaborations
Successful ageing is a key priority for many countries in the world, especially with a number of countries reaching
super-aged status (defined as having at least 20% of the total population aged 65 years and above) in the next
five to six years. There is much to learn from the experiences of countries who have undergone this demographic
transition. We aim to work with collaborators from the Asian countries such as China, Japan and South Korea to
understand what research questions are being studied and how comparisons can be made with the longitudinal
data that we have been collecting from the SLP.

Contribute to the ageing research ecosystem in Singapore

Since ROSA’s inception in 2020, the team has facilitated numerous meetings with organisations and researchers
who are keen to better understand the ageing landscape and trends in Singapore and work on implementing
possible policies and solutions from an evidence-based perspective. This includes fielding one-off modules to
the SLP, preparing research briefs and reports based on emerging trends and raising the awareness of topics that
impact older adults’ well-being in Singapore. We will continue our efforts in this area and communicate our findings
more effectively to key stakeholders such as the Ageing Planning Office and the AIC.

ROSA 2.0
Our research findings support the exploration of successful ageing from a life-course perspective. Thus, we have
developed a research proposal that outlines the refined hypotheses that we aim to test whilst introducing an even
younger cohort (those aged above 21) to the SLP. Another key component is to build on the conversations that we
have started with government agencies and the social sector to co-curate research questions that may be useful
for policy work.

24 Empowering Ageing-in-place
 Acknowledgements
We would like to express our gratitude for the able assistance of the following
ROSA staff in putting together this report:

Zidane Tiew

Hiah Wei Tin

Rachel Ngu

Lim Wensi

Empowering Ageing-in-place 25
About the Centre
for Research on
Successful Ageing
(ROSA)
ROSA is a multidisciplinary research centre based
in SMU. It was established with an MOE Tier 3 social
sciences research grant, as well as the generous support
of The Ngee Ann Kongsi. Research at ROSA seeks to
define and measure a holistic construct of well-being
and to identify the factors that impact Singaporeans’
well-being as they progress through the later phases
of life. Through close collaboration with government
and other partner agencies, ROSA also aims to
translate research insights into policy innovations that
advance the well-being of older adults holistically and
promote successful ageing in Singapore. ROSA brings
together a diverse team of leading international and
local researchers in ageing and age-related issues
from various disciplines. Through empirical evidence
derived from a longitudinal methodological approach,
the multidisciplinary and multi-institutional research
team advances propositions that promote successful
ageing in Singapore. The work at ROSA is supported
by The Ngee Ann Kongsi and the Ministry of Education,
Singapore, under its Academic Research Fund Tier 3
program award reference number MOE2019-T3-1-006.

26 Empowering Ageing-in-place
Our Supporters
The Ngee Ann Kongsi
The Ngee Ann Kongsi is a non-profit Teochew
philanthropic organisation focused on educational,
cultural and charitable activities in Singapore, while
placing a deep emphasis on preserving the Teochew
heritage. The organisation is an active advocate
in education. It was founded in 1845 by Teochew
immigrants from China to provide welfare services for
its members, and was formally incorporated under the
Ngee Ann Kongsi (Incorporation) Ordinance in 1933.

The Ministry of Education, Singapore

The research at ROSA is also supported by the Ministry
of Education, Singapore, under its Academic Research
Fund Tier 3 programme (Award reference number
MOE2019-T3-1-006). Any opinions, findings and
conclusions or recommendations expressed in this
material are those of the author(s) and do not reflect
the views of the Ministry of Education, Singapore.

Empowering Ageing-in-place 27
 Centre for Research on Successful Ageing
Singapore Management University – School of Social Sciences
10 Canning Rise, #05-01, Singapore 179873

rosa.smu.edu.sg [email protected]

Information is correct as of October 2024.