Speech by Dr Amy Khor, Senior Minister of State for Health, at the 27th REVES Scientific Meeting, 2 June

Dean designate, Professor Thomas Coffman, 

Senior Vice Dean, Professor Patrick Casey, Duke-NUS

Associate Professor Angelique Chan, Executive Director, CARE, Duke-NUS

Distinguished speakers

Guests

Ladies and gentlemen

Good morning. It gives me great pleasure to join you this morning for the Duke-NUS Centre for Ageing, Research and Education or CARE’s inaugural international conference on ‘Healthy Life Expectancy’.

A WORLD OF LONGER LIVES

2.         We are living in a world of longer lives. Across the globe, countries are facing the demographic reality of an ageing population. In many countries, the proportion of people aged 60 years and above is growing faster than any other age group. An ageing population is a result of both falling fertility and rising longevity. While population ageing may be due to progress in science, technology and medicine, it also forces societies to make changes to adapt to this new demographic reality.

3.       Part of the adaptation requires re-looking at how we re-organise healthcare and social support services to meet the needs of a fast ageing population. In many countries, population ageing is forcing a rethink on models of care, and even healthcare financing systems, to ensure that the healthcare system remain sustainable in the context of rapid population ageing.

4.        But I will argue, that part of our response to population ageing, should also be innovation to unleash the potential from our ever increasing longevity. If we can extend the "health span" of our population at the same rate, if not faster, than the rate of expansion of our life span, then there is no reason why older people cannot be a key driving force for economic and social development, alongside our younger people.

 5.        In fact, the concept of healthy life expectancy has been gaining ground in recent years. For example, Japan has recently prioritised increasing healthy life years in its health promotion efforts. The European Commission has also identified an increase in healthy life years as one of its targets for the European Innovation Partnership on Active and Healthy Ageing.

6.      This conference brings together leading experts in healthy life expectancy from different parts of the world to shed light on determinants of healthy life expectancy such as gender, education and health behaviours. We need multi-disciplinary teams to look into issues such as delaying social isolation and frailty, lifelong learning, work and retirement and caregiving so as to help seniors live healthier and more active lives.

DUKE-NUS CENTRE FOR AGEING, RESEARCH AND EDUCATION

7.      Singapore is also ageing rapidly. The proportion of seniors aged 65 years is expected to double from 7% to 14% in just 19 years from 2000 to 2019. By 2030, about one in five residents will be aged 65 years and above.

8.      Rather than being immobilised by the fear of a “silver tsunami”, let us also focus on the silver lining – which is that Singaporeans are living longer and living healthily for longer. In 1965, our average life expectancy was only 65 years old. Today, Singapore has the fourth highest average life expectancy in the world at 83 years^. Our health-adjusted life expectancy (HALE) which provides an estimate of the average years in ‘healthy life’ a person can expect to live at birth increased from 70.4 years in 2004 to 73.3 years in 2010 for males. Similarly, it increased from 73.7 years in 2004 to 77.7 years in 2010 for females.

9.      In planning to support an ageing population ahead, Singapore will place equal emphasis on enhancing health, aged care and social support on the one hand, and on promoting active ageing on the other. We believe that through planning ahead, such as encouraging lifelong learning, lifelong employability, senior volunteerism, and investing in preventive health, we can further expand the health span of our seniors and add more life to years.

10.    One way to achieve this is through research and innovation. We will invest in ageing-related research now, so that we can innovate new ways to positively transform the experience of ageing for Singaporeans in the next couple of decades.

11.    Therefore, I am pleased to introduce CARE, a new centre set up by the Duke-NUS Graduate Medical School. The key mission of CARE is to facilitate multidisciplinary research that will lead to solutions that are relevant to the needs of Singapore. Today, ageing-related research focuses more on age-related physiological and clinical phenomena. CARE aims to value add by focusing on how social dimensions can contribute to successful ageing, and more importantly, to serve as a platform for scholars from different disciplines to come together to engage in multi-disciplinary research. CARE investigators in social science, engineering, architecture, and health technology research will engage in collaborative work with clinicians and biological scientists.

12.    For a start, CARE will focus on four themes: (i) social integration and health, (ii) resilience, (iii) caregiving and the family and (iv) work, lifelong learning and social engagement. I am pleased to note that CARE has already made headway in some of these areas. For example, we know that mortality risk is traditionally calculated using the number and types of diseases present. However, research at CARE has shown that this risk can be modified by levels of loneliness. An older adult with diabetes who is lonely has a significantly higher mortality risk as compared to his counterpart who is not lonely. These findings on social isolation can advise policymakers and urban planners on how we should structure our living environments.  It can potentially guide policy and design strategies for housing and public spaces, so as to encourage social interaction, inter-generational bonding, as well as exercise and learning among seniors.

13.    CARE also hopes to distinguish itself by focusing on practice-oriented research.  CARE will partner practitioners and policy makers to ensure that research outcomes are ready for real world application in Singapore. For instance, CARE researchers worked with practitioners from Tsao Foundation to evaluate the Self-Care on Health of Older Persons in Singapore programme, or SCOPE.  This is an initiative by the International Longevity Centre in Singapore (ILC Singapore). SCOPE aims to empower seniors with the necessary psycho-social skills and self-care knowledge to lead active lives and be a positive influence on their peers in the community. The programme introduces a self-care approach, empowering seniors to maintain health, control chronic diseases and improve their functional status and quality of life. A total of 378 senior residents across 14 senior activity centres in Bukit Merah, Queenstown, Tiong Bahru and Ang Mo Kio attended the SCOPE training programme. Over 7 months they were trained in topics such as stress management, positive thinking, physical care and chronic disease management. After the training programme, the seniors continue to meet on a weekly basis on their own. This encourages community spirit, bonding and personal ownership of one’s health.  

14.    The evaluation results showed that older adults in the programme were more likely to fill their prescriptions and have a greater number of visits to their General Practitioners (GPs) as compared to those who did not undergo SCOPE.  The evaluation also suggested areas of improvement in the training programme such as the need to improve nutrition for seniors and the need to simplify communication between seniors and their GPs. Taken together, this programme evaluation undertaken by CARE helps guide practitioners on what works and what needs further improvement.

CONCLUSION

15.    I would like to congratulate Duke-NUS on the establishment of CARE and thank the Tsao Foundation for its kind donation to the effort.  I would also like to take this opportunity to encourage practitioners from various disciplines to engage in more ageing-related research. Together, we can transform ageing in Singapore in the future, and build a Nation for All Ages.

16.    Let me wish you a fruitful conference and a pleasant stay in Singapore.

Thank you.