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 are conducting S-LABS (Singapore Longitudinal Brain Aging Study) 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.

We will carry out functional imaging on a subset of volunteers to evaluate the pattern of brain reorganization observed in healthy elderly and to examine if the provision of different mental strategies will lead to the re-instatement of 'young' patterns of activation. We will also probe the profiles of people who show slower evolution of structural and functional changes to uncover the factors that contribute to their favourable state. In addition to the imaging and behavioural studies, we are collecting blood specimens with the long-term objective of contributing to the genetic characterization of the study group.

As of July 2009, S-LABS has successfully completed Wave 2 of recruitment. A total of 349 persons participated in Wave 1 and an additional 40 volunteers were recruited in Wave 2. Wave 3 will commence in September.

In our first report recently published in Neuroimage (Chee et al., 2009), we reported the effect of age and health variables known to modulate cognitive aging on several measures of cognitive performance and brain volume in healthy, non-demented persons of Chinese descent aged between 55 and 86 years. 248 subjects contributed combined neuropsychological, MR imaging, health and socio-demographic information. Speed of processing showed the largest age-related decline. Education and plasma homocysteine levels modulated age-related decline in cognitive performance. Total cerebral volume declined at an annual rate of 0.4%/yr. Gray and white matter volume loss was comparable in magnitude. Regionally, there was relatively greater volume loss in the lateral prefrontal cortex bilaterally, around the primary visual cortex as well as bilateral superior parietal cortices. Speed of processing showed significant positive correlation with gray matter volume in several frontal, parietal and midline occipital regions bilaterally. In spite of differences in diet, lifestyle and culture, these findings are broadly comparable to studies conducted in Caucasian populations and suggest generalizability of processes involved in age-related decline in cognition and brain volume.

The second cohort-specific report will evaluates the significance of white matter hyperintensities in our relatively healthy volunteers.

We have several manuscripts under review involving work led by Vitali Zagorodnov. These works concern the improvement of data pre-processing for structural brain studies – skull stripping, bias field / inhomogeniety correction.

In the functional imaging realm, we showed that elderly Chinese Singaporeans have reduced visual processing resources such that they show some difficulty processing a prominent object in the setting of a background scene (Chee et al., 2006). This processing deficiency may be influenced by cultural biases in the way scenes are processed (Goh et al., 2007).

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