Non-invasive neuroimaging measurements combined with physiological, neurocognitive and biota-based biomarker measurements as predictors of health outcome in ageing 

Age-associated disability and diseases are placing a growing burden on society, in general. In Singapore, in particular, these issues are now-a-days in the fore due to the fast ageing of the Singaporean society and the rapid increase of age-related disorders, including dementias. 

A better understanding of the ageing process, with special regard to the ageing of the brain, would help us prepare protective and preventive strategies as well as treatments to slow down the pathological ageing process, thereby decrease both individual and societal burdens. Hence, markers of the underlying biological ageing process are needed to help identify people at increased risk of age-associated physical and cognitive impairments and ultimately, death. 

For this reason the search for early predictive biomarkers indicating normal versus pathological ageing, in general, and brain ageing, in particular, is in the forefront of ageing research. Recently, non-invasive structural neuroimaging approaches have shown significant advancements in this field and some of the findings indicate firmly that non- invasively obtained neuroimaging biomarkers can provide us with reliable and predictive information about the person’s “brain age”, progression of ageing, and mortality (Cole et al., Brain age predicts mortality, Molecular Psychiatry, 2017 Apr 25. doi: 10.1038/mp.2017.62).

The above study has indicated that a brain-predicted age, indicative of an older-appearing brain, is associated with weaker grip strength, poorer lung function, slower walking speed, lower fluid intelligence, higher allostatic load and increased mortality risk. Furthermore, the combination of brain-predicted age and DNA-methylation-predicted age improves mortality risk prediction and thus can provide us with a strong predictor of health outcomes. Consequently, the combination of distinct measurements of biological ageing, including non-invasive neuroimaging, helps to determine risk of age-related deterioration and death.

The present projects aims at introducing the neuroimaging protocols of the aforementioned UK study, together with the introduction of complimentary biomarker measurements (including neurocognitive, physiological, and biome measurements) in a Singaporean cohort of healthy ageing people with an eye on identifying early predictive biomarkers of normal and pathological ageing and developing a protocol for screening larger populations in the future.