Asia is getting older. Across the region, a profound demographic shift is taking place; by 2050, at least 11 countries will be classified by UN standards as ‘super-aged’ nations, with over a fifth of residents comprising people aged 65 years and above.
“As Singapore itself is set to reach super-aged status as early as 2026, this trend understandably presents significant challenges in healthcare, economics, environment and social dynamics; not just for Singapore, but for the Asian region,” said Sze-Wee Tan, Assistant Chief Executive at A*STAR’s Biomedical Research Council (BMRC).
Among these challenges are the rising demand for and costs of healthcare services, driven by a projected uptick of age-associated chronic conditions like cardiovascular disease, diabetes and dementia. Shrinking workforces will reduce the productivity of national economies, while smaller families will bear greater emotional and financial caregiving burdens.
In preparation for an aged nation, A*STAR researchers are spearheading efforts that align with Singapore’s 2023 Action Plan for Successful Ageing. “A key national priority is to narrow the gap between our 84-year average lifespan and our 74-year ‘healthspan’, ensuring people enjoy more years of good health and functional ability,” said Tan, speaking on the goals of initiatives such as Age Well SG and Healthier SG.
A cellular view of ageing
What constitutes healthy ageing at a fundamental level? At A*STAR, multidisciplinary teams drawing from institutes such as the Institute of Molecular and Cell Biology (IMCB) and the Genome Institute of Singapore (GIS) are diving for insights on the genetic and cellular determinants of ageing, focusing on Asian-specific factors.
At GIS’s Laboratory of Metabolic Disease and Ageing Genomics, a team led by Principal Scientist Rajkumar Dorajoo is using advanced genomic techniques and longitudinal studies to link specific genetic variants in Asians to biomarkers of ageing, including those linked to increased cancer risk.
Working with the National University of Singapore (NUS), Dorajoo's group has pinpointed genetic markers linked to shorter telomeres—DNA regions which protect the ends of our chromosomes. Based on data from the 20-year Singapore Chinese Health Study cohort involving over 63,000 older adults, some of these markers are more prevalent in East Asians and associated with increased colon cancer risk.
"Our findings underscore the importance of personalised health strategies based on genetic backgrounds to anticipate and treat age-related diseases among Asians," said Dorajoo. “To expand on them, we’re also working with the Bioinformatics Institute (BII), NUS and the Lee Kong Chian School of Medicine (LKCMedicine) under the National Precision Medicine Programme’s SG10K Health project to evaluate epigenetic age acceleration and telomere length attrition in 10,018 Singaporeans of various ethnic ancestries.”
As we age, chemical tags on our DNA—known as epigenetic markers—also shift, subtly setting the stage for age-related disorders. A group led by Wee-Wei Tee, Programme Co-Director of Cancer Signalling and Therapies at IMCB, aims to identify these changes to provide potential targets for treatments that can reduce the risks of neurodegenerative diseases like Alzheimer’s.
“We’re developing strategies to understand how heterochromatin is lost as ageing occurs in different cells, starting with human neurons,” said Tee. “Our group had previously discovered novel molecular regulators that play a key role in early life development, but conversely have a negative effect on the epigenome with age.”
To aid advanced research, the team is also developing human cellular ageing models which more accurately mirror ageing’s complexities at the molecular and cellular levels, using advanced techniques such as transdifferentiation and induced pluripotent stem cell technology. “We’ve also launched a Cellular Ageing Programme at IMCB that unites researchers focusing on various molecular hallmarks of ageing,” said Tee.
Spotlight: Cellular tune-ups
Cellular regeneration is an avenue of interest to reverse the impacts of ageing cells. Researchers like Jonathan Yuin-Han Loh, Director of IMCB’s Cell and Molecular Therapies Programme, are pioneering cell therapies to combat diseases associated with ageing.
“Stem cells have an enormous plasticity in being reprogrammable into different cell types of the human body,” said Loh. “Because of that, stem cells hold great promise in cell replacement therapies for ageing-related conditions and diseases.”
Loh’s team found that certain proteins are crucial in controlling how pluripotent stem cells either maintain themselves or transform into different cell types. This breakthrough links specific genetic mechanisms directly to how stem cells behave, creating possibilities for generating high-quality stem cells that are safe for treating diabetes, Parkinson’s disease and other conditions by repairing damaged tissues or replacing diseased cells.
Wellness inside and out
Taking a wider view, A*STAR researchers are examining the effects of interplaying lifestyle factors on our bodies over time. David Cameron-Smith, Head of the Singapore Institute of Food and Biotechnology Innovation (SIFBI)’s Nutrition Capability Group, notes that despite the overall accessibility of healthy nutrition for Singapore’s elderly, they aren’t consuming enough essential nutrients.
“Only half of our senior population is consuming enough protein to meet their body’s needs,” said Cameron-Smith. Research by SIFBI and the Singapore Institute for Clinical Sciences (SICS) shows that as people age, they not only tend to eat less, but make nutritionally poorer food choices. Many in Singapore consume salt and saturated fats in excess, increasing the risk of hypertension, stroke and heart disease.
Together with NUS and the National University Health System, the Clinical Nutrition Research Centre (CNRC) at SIFBI is studying a collective studying how food can help prevent and manage chronic diseases. Key directions of CNRC research include how what we eat affects our metabolism, body composition and overall health; as well as our sensory and cognitive relationships with food.
"SIFBI also works closely with the Singapore Food Agency through the Singapore Food Story initiative, where we’re investigating the nutritional value and sustainability of next-generation alternative protein products,” said Cameron-Smith. “This effort aims to enhance the design and development of food products suited to an older population, emphasising a sustainable and diverse food supply."
Beyond our gut, A*STAR researchers are also examining our skin. At the Skin Research Institute of Singapore (SRIS)—a tripartite collaboration between A*STAR Skin Research Labs (A*SRL), the National Healthcare Group (NHG) and Nanyang Technological University, Singapore (NTU)—investigators are revealing unique differences in the course of skin health in Singapore's Chinese, Malay, and South Indian populations, compared to those of more extensively studied Caucasian and African ethnic origins.
“Skin lightens as it gets older, making it more susceptible to ultraviolet radiation,” said Rachel Watson, Executive Director of SRIS and A*SRL, adding that the risk was reflected in rising reports of skin cancer among Singaporeans. “We also see inflammation driving skin pathologies in old age, as well as more fungal infections tied to our tropical climate.”
This year, SRIS received a S$13 million public grant to conduct the Cutaneous Ageing and Maintenance Programme (CAP), a cohort-based study that will explore the ageing trajectory of Asian skin phenotypes. Aided by ecosystem partners such as BII, GIS and the Singapore Immunology Network (SIgN), as well as LKCMedicine and NHG’s National Skin Centre, CAP will run across four years and enlist over 700 Singaporean participants to identify early biomarkers of Asian skin ageing that aid preventive strategies for prolonged skin health.
Robotic helping hands
Singapore’s vision centres around ageing-in-place—ensuring seniors live independently in their communities, supported by digital technologies like telemedicine and smart home devices. With the help of artificial intelligence (AI), these tools can also help researchers understand the unique needs of older adults and provide them with personalised physical and cognitive support.
To support that vision, researchers like Wei Yun Yau, Head of the Robotics and Autonomous Systems Division at the Institute for Infocomm Research (I2R), are making robots more interactive and enhancing them with human-like intelligence, widening their use not just in hospital logistics, nursing and rehabilitation, but also in private homes and community care centres.
"Robots could assist in delivering medicines and supplies and providing housekeeping; or monitoring patients in need of constant care, getting feedback from them or escorting them as they move around. This would free healthcare workers for higher-value skilled tasks," said Yau. “Robots could also provide more channels for patient interaction, monitor health needs, and guide physiotherapy sessions after strokes or major operations.”
Yau’s team is equipping robots with communication skills like voice, visual and gesture recognition tailored to local needs, allowing users to command them easily using familiar language. The team’s strategy includes making robots more adaptable and cost-effective by implementing machine learning for autonomous recognition and task learning, reducing programming and integration costs in healthcare and facilities management.
In tandem with these efforts, Kenneth Kwok, Deputy Director of Social and Cognitive Computing at the Institute of High Performance Computing (IHPC), is leading the development of human-centric computing methods, aiming to create AI systems that respond effectively to human behaviour.
"We’re focused on developing AI that provides contextualised assistance,” said Kwok. “Human-centric AI can be deployed as smart assistants and intelligent robots to help seniors extend their working lives and their ability to contribute to society.”
With partners from I2R, the Advanced Remanufacturing and Technology Centre (ARTC), NUS, NTU and the Singapore University of Technology and Design, IHPC led the Collaborative AI project, an advanced manufacturing and engineering programme that aims to develop robots that can be taught to perform tasks like human teammates, making them more user-friendly for older workers.
Cognitive companionship
Integrating AI into the daily routines of seniors can also boost their cognitive abilities and social connections, promoting enriched, independent living. Qianli Xu, an I2R Scientist, explained: “It’s about human-AI synergy, where, with the help of AI, a person becomes more capable of taking care of themselves and others.”
In partnership with Singapore Management University (SMU), Xu's team created a conversational AI agent that features customisable, easy-to-use interfaces and digital avatars resembling caregivers. The digital tool aims to blend human insight with AI's computational strengths, creating intelligent systems to enhance situational awareness and provide targeted assistance.
"It can help individuals with their mobility, mental health and social engagement, while creating safer, smarter environments," Xu explained, adding that the team is currently refining this technology with Dementia Singapore for use in community settings.
With an ageing population, dementia is a particular healthcare burden projected to grow, casting a shadow over patients and caregivers alike. Jason Yanzhen Yue, an IHPC Senior Scientist, is another A*STAR researcher that envisions easing this pressure through digital technologies for early detection and management.
“As dementia has become a significant public healthcare challenge, early interventions that can help identify and modify relevant risk factors that lead to dementia are critical,” said Yue.
Yue’s team is exploring how Digital Health Interventions (DHI) such as mobile apps and wearable smart devices could impact dementia prevention measures among older populations. “These allow users to conduct self-administered screenings for dementia risk factors, and provide personalised early intervention and lifestyle strategies based on those factors,” said Yue.
Yue’s team is also developing the CareEco system in conjunction with Duke-NUS Medical School and Khoo Teck Puat Hospital, which uses DHIs to support caregivers of people with dementia, as well as ensure safe, independent living for dementia patients. “CareEco recommends customised coping strategies based on different care needs, and allows caregivers to monitor the elderly while attending to other life duties,” said Yue.
A future of living well
Singapore aims to become a Blue Zone 3.0: where strong community ties, healthy eating and purposeful living can support people in longer, healthier lives for its people. According to Mary Kan, Director of MedTech at A*STAR, focused technological developments in medical sensors and multi-modal AI at A*STAR—coupled with user-centric design—will shape the future of healthy ageing in Singapore.
“Throughout the ageing continuum, the clinical and consumer-level medical and health technologies we develop with our ecosystem partners will help both in understanding health states—risk factors and disease markers—as well as disease management, particularly for chronic conditions like diabetes in later life,” said Kan.
Collaborating extensively with healthcare clusters, policymakers and industry stakeholders, A*STAR has a strong track record of transitioning high-TRL (Technology Readiness Level) solutions from labs to community use. Sze-Wee Tan noted that this approach not only protects intellectual property but also drives local innovation, boosting the economy and benefiting communities in Singapore and beyond.
Tan added that achieving a healthy ageing future requires a comprehensive strategy that encompasses behavioural sciences, preventive health research, healthcare innovations and assistive technologies. “By leveraging research and technology, A*STAR aims to increase the healthspan of Singapore’s people across their life course, enhancing their health, function, quality of life and productivity,” said Tan.
