PopulatION HEalth and Age-Related SEnsory Decline PRofilE (PIONEER)

Overview

The PopulatION HEalth and Age-Related SEnsory Decline PRofilE (PIONEER) is Singapore's flagship longitudinal population-based cohort investigating the role of sensory health in healthy ageing. 

Led by Professor Ecosse Lamoureux and Assistant Professor Preeti Gupta, the programme is conducted by the Population Health Research Group at the Singapore Eye Research Institute (SERI). 

PIONEER is a nationally representative longitudinal cohort of older Chinese, Malay and Indian Singapore residents aged 60 years and above. The study integrates detailed evaluations of vision, hearing and olfaction with advanced retinal imaging, biological sampling, body composition analysis, physical function, cognition and lifestyle measures to better understand the epidemiology, determinants and consequences of age-related sensory decline and healthy ageing.

The Team

Back row (L to R): Melisa, Ang Poh Hoon, Prof Ecosse Lamoureux, Teo Hui Ting, Nurul Sofea Binte Endy Supanti, Sharanna Kuppusamy, Boh Hui Hui

Seated: Amudha Aravindhan, Dr Preeti Gupta, Aricia Ho Xin Yi

The PIONEER at a Glance

Our Objectives

PIONEER aims to:

• Determine the prevalence, risk factors, incidence, and predictors of age-related vision, hearing and olfactory impairment.
• Understand how sensory decline influences cognition, mobility, musculoskeletal health (i.e., frailty, sarcopenia, and osteoporosis), sleep, mental health, falls and quality of life (QoL).
• Quantify the clinical, societal and economic burden of single and multiple sensory impairments.
• Identify biological and lifestyle determinants of healthy ageing.
• Generate evidence to inform preventive strategies, clinical practice and healthcare policy.

Comprehensive Assessments

_{Participants undergo standardized assessments across five complementary domains.}

Research Focus Areas

Current research focuses include:

• Sensory Health & Healthy Ageing – Investigating how the severity and laterality of age-related vision, hearing and olfactory impairment influence frailty, cognition, mobility and other ageing outcomes.
• Artificial Intelligence & Retinal Biomarkers – Developing and validating AI-enabled retinal screening tools for early detection of sarcopenia and other systemic age-related conditions.
• Cognitive Ageing – Validating VISION-Cog, a vision-independent neuropsychological assessment designed to improve the detection of cognitive impairment in visually impaired older adults.
• Musculoskeletal Ageing – Establishing Singapore-specific, sex- and ethnicity-specific DXA-derived reference values for low muscle mass and validating novel measures of muscle health, including the Deuterated Creatine (D₃Cr) dilution method.
• Healthspan & Multimorbidity – Developing Singapore-specific multimorbidity indices to better quantify healthspan and predict healthy ageing trajectories.

Our Vision

To be a world-leading research programme advancing the understanding of sensory health and healthy ageing in Asia through innovative, multidisciplinary and collaborative research.

We aspire to:

• Generate transformative evidence on sensory health and ageing.
• Advance precision medicine and translational research.Inform clinical practice and public health policy.
• Foster national and international collaborations.
• Train the next generation of clinician-scientists and researchers.

Why PIONEER Matters

As populations age worldwide, sensory impairment is increasingly recognised as a major contributor to disability, frailty, cognitive decline and loss of independence. PIONEER addresses this challenge by providing a nationally representative, multi-ethnic longitudinal research platform that generates evidence to:

• Define the epidemiology and determinants of sensory decline in Asian populations.
• Identify early predictors of adverse ageing outcomes.
• Support preventive strategies and healthy ageing.
• Inform healthcare planning and public health policy.
• Enable national and international collaborative research.

Methodology paper DOI:10.14336/AD.2020.0206.

Team

Programme Leads

• Professor Ecosse Lamoureux
• Assistant Professor Preeti Gupta

Investigators 

• Associate Professor Ryan Man Eyn Kidd
• Adjunct Associate Professor Eva Fenwick

Programme Management & Research Staff

• Angelina Lee Hui Pheng
• Arica Ho Xin Yi
• Teo Hui Ting
• Melisa
• Nurul Sofea Binte Endy Supanti
• Ang Poh Hoon
• Crystal Chong Chun Yuen
• Boh Hui Hui
• Sharanna Kuppusamy

Collaborators

PIONEER has established a multidisciplinary network of collaborators across Singapore and internationally to advance research in sensory health and healthy ageing.

Singapore

• Singapore National Eye Centre (SNEC)
• Singapore Eye Research Institute (SERI)
• Duke-NUS Medical School
• Singapore General Hospital (including Nuclear Medicine & PET and Otolaryngology–Head & Neck Surgery)
• National Heart Centre Singapore
• National Dental Centre Singapore
• National Neuroscience Institute
• Sengkang General Hospital
• Changi General Hospital
• National University of Singapore
• National Cohort Office
• Clinical Nutrition Research Centre
• Singapore Institute for Clinical Sciences

International

• University of California, Berkeley (USA)
• Wilmer Eye Institute, Johns Hopkins University (USA)
• Duke University Aging Center (USA)
• Queensland University of Technology (Australia)
• Centre for Eye Research Australia, University of Melbourne (Australia)
• ETH Zurich (Switzerland)
• Imperial College London (UK)

Selected Publications

1. Tai-Anh Vu, Samuel T. H. Chew, Sahil Thakur, Hiromi Yee, Ryan E. K. Man, Eva K. Fenwick, Amudha Aravindhan, Belicia Lim Jia Yi, Preeti Gupta, Ecosse L. Lamoureux. The Association Between Visual Function Deficits and Poor Muscle Health in Multiethnic Older Asians: The Pioneer Study. JCSM Communications. Volume 9, Issue1 January/June 2026 e70020. [Link]
2. Yee H, Ho AXY, Wong CMJ, Tan WL, Fenwick EK, Gupta P, Ng ASL, Vu TA, Doshi K, Lamoureux EL, Man REK. Evaluating the Acceptability and Pilot Diagnostic Accuracy of a Visually Independent Test Battery of Neurocognition (VISION-Cog). Med Sci (Basel). 2026 Jun 24;14(3):344. [PMID: 42506313]
3. Chandran M, Wong CMJ, Helgason B, Leong YE, Chan A, Malhotra R, Gupta P, Jha D, Praveen AD, Tan DYZ, Choo HMC, Lamoureux EL. Revisiting the Osteoporosis Self-Assessment Tool (OST): evidence from a multi-cohort study in Asia supporting age-dependent thresholds. Osteoporos Int. 2026 Jun 26.  [PMID: 42360325]
4. Peng Q, Xue CC, Chua K, Li H, Nusinovici S, Soh ZD, Gupta P, Leem AY, Yu MCY, Sabanayagam C, Rim TH, Zhu Z, Lamoureux E, Cheng CY. Retinal biological age correlates with bone mineral density and fracture risk score and predicts incident osteoporosis. PLOS Digit Health. 2026 May 14;5(5):e0001360. [PMID: 42133570]
5.  Jha D, Zhou Y, Praveen  AD, Gallike  ES, Gupta P, Lamoureux EL, Hong N, Rhee Y, Pálsson H, Ferguson SJ, Helgason B. Dual-energy X-ray absorptiometry derived biofidelic finite element models for quantifying the efficacy of hip protectors. JMR Plus. 2026 Apr 14;10(6):ziag067. [PMID: 42110968]
6. Nooteboom I, Fenwick EK, Man REK, Wong JCM, Yeo BSY, Gao EY, Kye Jyn Tan B, Yee H, Ng JH, Wei Yang Teo N, Forde C, Lamoureux EL, Gupta P. Elucidating the burden of dual-sensory impairment in community-based older individuals in a multi-ethnic society. Sci Rep. 2026 Apr 2;16(1):16650. [PMID: 41927592]
7. Grgic J, Tey SL, Huynh DTT, Low YL, Pedisic Z, Schaller N, Wazny VK, Wang W, Saito Y, Rannan-Eliya RP, Ghattas H, Chaaya M, de Leon CM, Gupta P, Lamoureux EL, Subramaniam M, Abdin E, Malhotra R, Chan A, Tumenbayar B, Luvsandavaajav O, Enkhtuvshin B, Mansor N, Awang H, Maier AB. Asian Reference Values for Handgrip Strength, Gait Speed, Five-Times-Sit-to-Stand Test, Muscle Mass and Calf Circumference. J Cachexia Sarcopenia Muscle. 2026 Feb;17(1):e70216. [PMID: 41674016]
8. Zhang Y, Gupta P, Fenwick E, Man R, Wong CMJ, Tan ACS, Cheung CMG, Colega MT, Chong MF, Lai JS, Lamoureux EL. The Association of Dietary Patterns with Age-Related Macular Degeneration in a Multi-Ethnic Older Singaporean Population. Ophthalmologica. 2026 Jan 17:1-16. [PMID: 41546875]
9. Yee H, Wong CMJ, Gupta P, Thakur S, Fenwick E, Lamoureux EL, Man REK. Prevalence, Risk Determinants, and Burden of Undiagnosed Age-Related Eye Diseases Among Older Asian Adults. JAMA Ophthalmol. 2026 Jan 1;144(1):23-32.  [PMID: 41264299]
10. Jha D, Chandran M, Koller D, Cheong VS, Praveen AD, Baker A, Gupta P, Lamoureux EL, Pálsson H, Ferguson SJ, Helgason B. Relationship between areal BMD, FRAX®, and femoral strength in community-dwelling older Asian adults. Arch Osteoporos. 2025 Nov 4;20(1):139. [PMID: 41186781]
11. Jha D, Zhou Y, Praveen AD, Galliker ES, Gupta P, Lamoureux EL, Hong N, Rhee Y, Pálsson H, Ferguson SJ, Helgason B. DXA-based biofidelic finite element models for simulating falls to the hip: impact of trochanteric soft tissue thickness on fracture risk. Clin Biomech (Bristol). 2025 Nov;106720.  [PMID: 42110968]
12. Gupta P, Thakur S, Wong CMJ, Man REK, Fenwick EK, Sabanayagam C, Huang O, Low JR, Perera SA, Wong TT, Lamoureux EL. Glaucoma in Older Asians Aged 60 to 100 Years: Prevalence, Factors, Trends, and Projections (2024-2040). Invest Ophthalmol Vis Sci. 2025 Jul 1;66(9):62. [PMID: 40704860]
13. Gupta P, Chan A, Tai-Anh V, Man REK, Fenwick EK, Aravindhan A, Junxing C, Wood JM, Black AA, Ng JH, Cheng CY, Sabanayagam C, Lamoureux EL. Prevalence and Patient-Centered, Health-Related, and Economic Impact of Under-Corrected Refractive Error in Community-Based Older Singaporean Adults: A Population-Based Study. Invest Ophthalmol Vis Sci. 2025 Jun 2;66(6):3. [PMID: 40455043]
14. Vu TA, Fenwick EK, Man REK, Thakur S, Tan ACS, Cheung CMG, Gupta P, Lamoureux EL. Vision-related quality of life impact of age-related macular degeneration in older adults aged 60-100 years: a cross-sectional study. Br J Ophthalmol. 2025 Jun 23;109(7):822-828. [PMID: 40240124]
15. Gupta P, Vu TA, Wong CMJ, Thakur S, Black AA, Wood JM, Man REK, Fenwick EK, Lamoureux EL. Single and Multiple Visual Function Impairments and Associated- Vision-Related Quality of Life Impact in Older Adults Aged 60 to 100 Years. Invest Ophthalmol Vis Sci. 2025 Feb 3;66(2):18. [PMID: 39913162] 
16. Yeo BSY, Gao EY, Tan BKJ, Ong BDC, Cho RWY, Lim CY, Man REK, Enwick EF, Gupta P, Chen CL, Chew STH, Teo NWY, Toh ST, Ng JH, Tan VYJ, Lamoureux, EL. Dual sensory impairment: global prevalence, future projections and its association with cognitive decline. Alzheimers Dement. 2025 Feb;21(2):e14465. [PMID: 39887563]
17. Man REK, Wong CMJ, Gupta P, Fenwick EK, Aravindhan A, Teo NWY, Charn TC, Forde C, Lamoureux EL. Understanding the prevalence and Risk Factor Profile of Olfactory Impairment and Its Impact on Patient Health Indicators and Economic Outcomes in Community-Dwelling Older Asian Adults. Innov Aging. 2024 Sep 27;8(10):igae088. [PMID: 39403447]
18. Gupta P, Vu TA, Man REK, Fenwick EK, Tay L, Yee Sien N, Ng D, Frederick KHX, Yong EL, Chew STH, Lamoureux EL. The prevalence patterns and risk factor profiles of poor muscle health and its associated components in multiethnic older Asians: The PIONEER study. J Cachexia Sarcopenia Muscle. 2024 Aug;15(4):1376-1387. [PMID:38646827]
19. Gupta P, Chan A, Tai-Anh V, Man REK, Fenwick EK, Aravindhan A, Junxing C, Wood JM, Black AA, Ng JH, Cheng CY, Sabanayagam C, Lamoureux EL. Prevalence, associated risk factors; and patient and economic impact of multiple sensory impairment in a multi-ethnic elderly population in Singapore: the PIONEER study. BMC Public Health. 2024 Apr 22;24(1):1102. [PMID: 38649854]
20. Heng MWY, Chan AWD, Man REK, Fenwick EK, Chew STH, Tay L, Sien NY, Ng D, Koh FH, Yong EL, Gupta P, Lamoureux EL. Individual and Combined Associations of Sarcopenia, Osteoporosis and Obesity with Frailty In A Multi-Ethnic Asian Older Adult Population. BMC Geriatrics. 2023 Dec 5;23(1):802. [PMID: 38053025]
21. Fenwick EK, Gupta P, Chan AWD, Man REK, Aravindhan A, Ng JH, Cheng CY, Wong TY, Chan A, Teo NWY, Sabanayagam C, Lamoureux EL. The Impact of Hearing Impairment on Health Indicators in a Multiethnic Population of Older Adults in Singapore. Innov Aging. 2023 Sep 16;7(8):101. [PMID: 37886627]
22. Gupta P, Man REK, Fenwick EK, Aravindhan A, Gan AT, Thakur S, Soh BLP, Wood JM, Black AA, Chan A, Ng D, Hean TK, Goh E, Mary CF, Loo J, Forde CG, Sabanayagam C, Cheng CY, Wong TY, Lamoureux EL. Rationale and Methodology of The PopulatION HEalth and Eye Disease PRofile in Elderly Singaporeans Study [PIONEER]. Aging Dis. 2020 Dec 1;11(6):1444-1458. [PMID: 33269099]

Media

1.   流动眼科巴士诊所为弱势群体检查眼睛 | 联合早报

      Lianhe Zaobao (27 Nov 2017)

2.   Untreated ‘lao hua yan’ a major concern in rapidly ageing S’pore

      The Straits Times, Opinion (1Feb 2024)

3.  Sensory impairment widespread among older adults in S’pore: Study

     The Straits Times (23 Feb 2026)

4.   மூன்று மூத்தோரில் ஒருவர் கண் நோய் பற்றி அறிவதில்லை: கண்டறிந்தது ஆய்வு

      Tamil Murasu (23 Feb 2026)

5.   CNA938 Rewind - Sensory loss in seniors: A warning sign for brain health? - CNA

     CNA938 Rewind Podcast (25 Feb 2026)

6.   Forum: Expand scope of community health screenings

     The Straits Times Forum (27 Feb 2026)

Funders

PIONEER is supported by competitive funding from national research agencies and institutional partners including National Medical Research Council (NMRC), SingHealth DUKE-NUS Academia Medical Centre, National Health Innovation Centre (NHIC), National Cohorts Office (NCO), Lien Foundation, ETH Singapore SEC Ltd and Tan Ean Kiam Foundation.

Contacts

Principal Investigator: Professor Ecosse Lamoureux

Co-Investigator: Assistant Professor Preeti Gupta

Data Sharing Request

For data requests/inquiries, please contact:

Ms Crystal Chong Chun Yuen, Biostatistician

For data requests, please fill up the Research Data Request Form.