Abstract
To describe the rationale, design and methodology of a geographically-representative and population-based study investigating the epidemiology, impact, personal and economic burden of age-related eye diseases, declining visual and other sensory systems in Asians aged >60 years in Singapore.PIONEER (The PopulatION HEalth and Eye Disease PRofilE in Elderly Singaporeans Study) is currently a cross-sectional study targeting 3152 Chinese, Malay and Indian adults who are Singapore citizens or permanent residents aged 60 years and older living across Singapore. The study is intended to be longitudinal, with several waves of data planned to be collected in the future. The sampling frame consisted of 7000 names derived from age, gender and ethnicity-stratified random sampling of individuals >60 years. Selected individuals were invited via letters, home visits, and telephone calls for a clinical assessment at the Singapore Eye Research Institute. Individuals with limited mobility were examined in a custom-designed mobile eye clinic. Questionnaires were subsequently administered at participants’ homes by trained interviewers in their preferred language. A total of 3,299 participants (from East, West, North and South Singapore) were approached from December 2017 to November 2019. Of these, 953 (28.5%) were deemed ineligible. Out of 2,346 eligible participants, 904 (38.5%) refused, and 1,442 (61.5%) attended our clinical testing protocol, giving an initial response rate of 61.5%. Of these, 1,170 (81%) were cognitively able to complete the questionnaire assessment. The mean age±SD of our participants was 73.8±8.6 years; n=798 (55.3%) were female; and 828 (57.4%) were of Chinese ethnicity. The findings from this study will allow a deeper understanding of the risk factors and impact of aging in Asian populations, particularly in relation to the visual function and other functional system.
Highlights
To describe the rationale, design and methodology of a geographically-representative and population-based study investigating the epidemiology, impact, personal and economic burden of age-related eye diseases, declining visual and other sensory systems in Asians aged >60 years in Singapore.PIONEER (The PopulatION HEalth and Eye Disease PRofilE in Elderly Singaporeans Study) is currently a cross-sectional study targeting 3152 Chinese, Malay and Indian adults who are Singapore citizens or permanent residents aged 60 years and older living across Singapore
PIONEER assessment comprises two sessions including (1) a comprehensive clinical examination conducted at Singapore Eye Research Institute (SERI), or on a mobile eye clinic, a custom built bus outfitted with standardized clinic equipment; and (2) an extensive questionnaire protocol subsequently administered at the participant’s home in his/her preferred language, by trained interviewers
Upon completion and with information from all ethnic groups, PIONEER will likely contribute to new and much needed data of the burden associated with age-related sensory decline in Singapore to inform public health initiatives; and assist policy and decision makers in planning health care availability, utilization, and resource allocation
Summary
PIONEER is currently a cross-sectional, population-based and epidemiological study of Chinese, Malay and Indian adults who are Singapore citizens or permanent residents aged 60 years and older living across Singapore. The cognitive status of the participants is assessed using the 6 item Cognitive Impairment Test (6-CIT) [28] before proceeding with the study procedures For those who score ≥ 8 in 6-CIT (indicating mild cognitive impairment or worse) during the recruitment visit, the study details are explained to, and verbal consent obtained from, the primary caregiver. This definition includes all persons of Chinese, Malay or Indian origin, as indicated on the National Registration Identity Card, which is provided to all Singapore citizens and permanent residents We have used this definition in our previous population-based studies in Singapore [29,30,31]. The average of the three readings will be utilised in analyses
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