Newly developed societies in Asia are graying at 2-3 times the rate of the US and Western Europe. Between 1998 and 2030, the proportion of persons aged 65 years and over in Singapore will grow by about 3% annually compared to 1.0 - 1.3% in some developed nations. Unfortunately, research in Asian nations has not kept pace with these trends. While there are several longitudinal brain-aging studies in progress in the West, there have, till now, been no such initiatives in our part of the world.

Maintaining the highest possible level of cognitive functioning for as long as one is able has become an important goal of aging successfully. To better understand how elderly people in Asian societies can achieve this goal, we started S-LABS (Singapore Longitudinal Brain Aging Study) in 2005. S-LABS a comprehensive MRI based, longitudinal study of approximately 350 cognitively intact elders aged above 55 years. In this study, we will characterize the extent to which factors that result in either positive or deleterious effects on cognition affect brain structure and function.

As of September 2016, S-LABS has successfully completed Wave 6 of recruitment. A total of 349 persons participated in Wave 1 and slightly over 100 have followed us for 11 years – a remarkable achievement in Asia.

Much effort went into the initial design of the study paying careful attention to quality control of the imaging and behavioural data. This resulted in several publications about optimizing non-uniformity corrections, bias field correction and using graph cuts to perform skull stripping.

While waiting for data collection to accrue, we worked with Denise Park’s group on several communications relating to the effect of culture and cognition in young and older adults.

Our first cross sectional study reported the effect of age on several measures of cognitive performance and brain volume in healthy, non-demented persons of Chinese descent aged between 55 and 86 years (Chee et al., 2009). 248 subjects contributed combined neuropsychological, MR imaging, health and socio-demographic information.

Since that seminal cross sectional study, we added several others, speaking to hippocampal specific contributions to memory performance in elderly, the effects of homocysteine and visceral adiposity on cognition in the elderly.

When Dr. June Lo joined us from Surrey, we added sleep as a component to the evaluation of age –related effects – characterizing the effect of sleep in false memory formation. She performed a metanalysis of the effects of long and short sleep in cognitive decline in older adults.

We found that short sleep in older adults contributes to faster decline in an aggregate measure of cognitive performance as well as to faster ventricular expansion.

Together with Helen Zhou’s group we have found reduced functional segregation between the default mode network and the executive control network.

Singapore is a fast aging society and we are contributing to finding ways to allow aging persons to do so more successfully.

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