Super-aged, superlative: Ageing with meaning and dignity in Singapore

SINGAPORE – Singapore is on the brink of becoming one of the world’s fastest super-aged societies. By 2030,

one in four Singaporeans will be above the age of 65

.

This milestone is often portrayed as a looming crisis, one that threatens to overwhelm our healthcare system, shrink our workforce, and burden families. But this narrative overlooks an important truth: Ageing need not mean decline.

If we understand how the brain adapts, and how society can nurture both body and spirit, ageing can be superlative, a stage of resilience, growth and dignity.

For decades, mental health was framed around simplistic notions of “chemical imbalance” and the use of medications to correct the imbalance.

While this theory served its time, science now offers a far richer picture. Our brains are dynamic networks, constantly shaped by genes, environment, and lived experience.

Neuroplasticity, the brain’s ability to adapt, reminds us that older adults are not merely passengers of decline, but capable of learning, rewiring and flourishing well into later life.

Seniors can develop new skills, strengthen social bonds, and even recover from adversity. The challenge lies not in whether the brain can change, but in whether society offers the right conditions for it to do so.

Here, neurodiversity provides another important perspective. Human brains vary widely in how they function, and ageing magnifies this variation.

Some seniors may face challenges such as dementia, anxiety or depression. But others show remarkable strengths compared with younger counterparts, greater emotional regulation, perspective and wisdom.

Too often, ageing is described in terms of deficits. We speak of “cognitive decline” as though it were purely a loss. What if, instead, we framed these changes as “ageing differences”?

Just as society has embraced the neurodiversity movement, recognising autism, attention deficit hyperactivity disorder and other conditions as natural variations rather than disorders, so too can we reframe ageing.

This shift in mindset would call us to create environments that support seniors in their differences. For example, if cognitive processing slows, perhaps the answer is not to push older adults harder to “keep up”, but to design a gentler environment that does not move at a punishing speed.

In workplaces, communities and even public spaces, slowing down the pace, whether through clearer signage, more flexible policies or patient interactions, can allow seniors to thrive.

Rather than labelling ageing as a deficit, we can see it as part of the diversity of human experience, deserving of respect and accommodation.

Healthy ageing, however, is not only about biology. Mental well-being thrives at the intersection of body, brain and spirit. Research affirms that meaning, our personal search for purpose, relationships, and transcendence, is essential to resilience.

Without it, longer lives risk becoming hollow extensions of time. With it, years are infused with vitality and dignity.

In practical terms, this means designing communities and ecosystems where seniors are not passive recipients of care, but active contributors.

Befriending programmes, community-based mental health support and opportunities for intergenerational exchange are not luxuries. They are the infrastructure of meaning.

Social prescribing

is a powerful tool here. When doctors and healthcare providers can prescribe not only medications but also community activities, volunteer work, or arts and cultural groups, they help seniors remain engaged and connected.

A prescription for a choir session or a community garden may seem unconventional, but evidence shows it can reduce loneliness, improve mood, and even lower healthcare use.

Singapore’s tiered care model is an example of how we can operationalise this philosophy. Based on the international best practice of the stepped care model, it is being implemented as part of our national mental health and well-being strategy.

At the base of the pyramid are grassroots initiatives that promote mental literacy and help-seeking. At the next level are primary care teams in polyclinics and GP practices, who can detect early signs and provide low-intensity support.

At higher tiers, specialist centres like the Institute of Mental Health manage complex conditions, while community partners offer outreach, rehabilitation and psychosocial support. This system reflects an ecosystem approach: a web of care that supports individuals at different stages and needs.

NHG Health has been working to integrate both physical and mental health into this ecosystem. The recognition that body and mind are inseparable has shaped initiatives across our hospitals, polyclinics and community partners.

For example, in the central-north region, NHG’s integrated care model emphasises that a patient treated for diabetes or heart disease should also be screened for depression or anxiety, conditions that can directly affect physical health outcomes.

Social prescribing pilots in the region have also connected seniors not only to exercise classes and diet programmes, but to befriending schemes, caregiver support and arts activities that enrich mental well-being. By aligning physical and mental health care, NHG is showing how a health system can serve the whole person, not just the disease.

Yet as Singapore collectively ages, the challenge is to weave dignity into every layer of this model. Can a GP recognise not only hypertension but also loneliness? Can a hospital discharge plan include not only medications but also social prescribing?

Can employers and policymakers create opportunities for seniors to contribute meaningfully long after their official retirement age? The answers to these questions will shape whether our nation becomes not only super-aged but also superlative.

This vision of ageing with meaning and dignity is not just theoretical. My father, who died recently at the age of 93, embodied it in his own life. He worked faithfully in the same bank for his entire career, retiring at 55.

Yet, retirement did not mean withdrawal. He devoted his later years to his family, remaining mentally sharp and meaningfully occupied with his children, grandchildren and great-grandchildren.

He kept his days filled with purpose, whether through small routines, storytelling or simply being present. His passing at home, instead of the hospital, was a testament to what it means to live with meaning and to leave with dignity.

His story reminds us that ageing well is more than adding years to life; it is about adding life to years. Living with meaning means older Singaporeans remain seen, valued and engaged.

Leaving with dignity means ensuring that in our final chapters, we are not abandoned to isolation, but supported by systems of care and embraced by those we love.

As a psychiatrist, I sometimes describe myself as a neural network specialist. But our real task is broader: to help society network ecosystems of care are as vital as neurotransmitters.

We must advocate not only for treatments in the clinic, but also for compassionate policies, supportive environments, and a culture that honours ageing.

Singapore will be super-aged. Whether we are also superlative depends on the choices we make today. If we invest in ecosystems of care, embrace neurodiversity in ageing and empower seniors with opportunities for meaning, we can ensure that longevity is not an empty statistic but a celebration of life.