Family history of fracture and fracture risk: a meta-analysis to update the FRAX® risk assessment tool.

Unlabelled: In the largest meta-analysis of international cohorts to date, a family history of fracture is confirmed as a significant BMD-independent predictor of future fracture risk. Parental and sibling histories of fracture carry the same significance for future fracture, including the impact of family hip fracture on future hip fracture risk.

Purpose: We have undertaken a meta-analysis of international prospective cohorts to quantify the relationship between a family history of fracture and future fracture incidence.

Predictive capabilities of polygenic scores in an East-Asian population-based cohort: the Singapore Chinese health study.

Polygenic scores (PGS) are derived primarily from European population studies. It is unclear how these perform in risk predictions among East-Asians. We generated 2173 PGSs from 519 traits and assessed their associations with 58 baseline phenotypes in the Singapore Chinese Health Study, a prospective cohort of 23,622 Chinese adults residing in Singapore.

Body mass index and subsequent fracture risk: A meta-analysis to update FRAX®.

The aim of this international meta-analysis was to quantify the predictive value of body mass index (BMI) for incident fracture and relationship of this risk with age, sex, follow-up time and bone mineral density (BMD). 1 667 922 men and women from 32 countries (63 cohorts), followed for a total of 16.0 million person-years were studied.

Multi-ancestry polygenic risk scores for the prediction of type 2 diabetes and complications in diverse ancestries.

Background: Polygenic risk scores (PRSs) improve type 2 diabetes (T2D) prediction beyond clinical risk factors but perform poorly in non-European populations, where T2D burden is often higher, undermining their global clinical utility.

Methods: We conducted the largest global effort to date to harmonize T2D genome-wide association study (GWAS) meta-analyses across five ancestries-European (EUR), African/African American (AFR), Admixed American (AMR), South Asian (SAS), and East Asian (EAS)-including 360,000 T2D cases and 1·8 million controls (41% non-EUR). We constructed ancestry-specific and multi-ancestry PRSs in training datasets including 11,000 T2D cases and 32,000 controls, and validated their performance in independent datasets including 39,000 T2D cases and 126,000 controls of diverse ancestries.

Polygenic prediction of body mass index and obesity through the life course and across ancestries.

Polygenic scores (PGSs) for body mass index (BMI) may guide early prevention and targeted treatment of obesity. Using genetic data from up to 5.1 million people (4.

Association between consumption of ultra-processed food at midlife and handgrip strength at late life: The Singapore Chinese Health Study.

Objectives: Cohort studies with sufficient follow-up that include an assessment of overall diet quality are necessary to determine the prospective relationship between consumption of ultra-processed foods (UPFs) and muscle strength.

Design: Prospective cohort study.

Setting And Participants: We included 13,570 participants from the Singapore Chinese Health Study who were recruited at a mean age of 53 years from 1993 to 1998, and re-visited at follow-up 3 when they were at a mean age of 74 years from 2014 to 2017, after a median follow-up of 21.

The SG90 cohort of the oldest-old in Singapore.

The global population is ageing rapidly. While genetics, lifestyle, and environment are known contributors to healthspan, most insights are drawn from Western cohorts, leaving Asian populations underrepresented despite unique biological, lifestyle, and cultural factors. The SG90 cohort study aimed to fill knowledge gaps in healthy ageing by identifying modifiable medical, biological, lifestyle, psychological, behavioural, and social factors that contribute to longevity in the oldest-old.

Hormone therapy use and young-onset breast cancer: a pooled analysis of prospective cohorts included in the Premenopausal Breast Cancer Collaborative Group.

Background: Oestrogen plus progestin hormone therapy is an established risk factor for breast cancer in postmenopausal women. We examined the less well-studied association between exogenous hormones and breast cancer in young women, who might use hormone therapy after gynaecological surgery or to relieve perimenopausal symptoms.

Methods: In this pooled cohort analysis, we investigated the relationship between exogenous hormones and breast cancer in young women using data from 10-13 prospective cohorts from North America, Europe, Asia, and Australia.

From Digital Divide to Digital Equality: The Role of Learning in Older Singaporeans.

Objectives: The role of information and communication technology (ICT) in later life has received substantial attention, with continuous studies focusing on the digital divide for older persons. Literature usually defines and measures the digital divide by focusing on ICT accessibility, skills, and outcomes. This study attempted to expand this framework by further incorporating the role of learning for a more comprehensive perspective of understanding the digital divide at older ages.

Association between objectively measured, multidimensional sleep health and cognitive function in older adults: cross-sectional wearable tracker study.

Both sleep and cognition are multidimensional constructs. Using univariate methods to examine associations between sleep and cognition may inadequately characterize the association between these arrays of variables. The current study used a multivariate approach to identify key sleep metrics and cognitive domains contributing to the maximum sleep-cognition covariance in healthy older adults.

Alcohol intake and pancreatic cancer risk: An analysis from 30 prospective studies across Asia, Australia, Europe, and North America.

Background: Alcohol is a known carcinogen, yet the evidence for an association with pancreatic cancer risk is considered as limited or inconclusive by international expert panels. We examined the association between alcohol intake and pancreatic cancer risk in a large consortium of prospective studies.

Methods And Findings: Population-based individual-level data was pooled from 30 cohorts across four continents, including Asia, Australia, Europe, and North America.

Association Between Cardiometabolic Multimorbidity and 15-year Mortality in the Asia Cohort Consortium.

Background: Studies on the association between multimorbidity and mortality in large populations have mainly been conducted in European and North American populations. This study aimed to identify the association between cardiometabolic multimorbidity and all-cause and cardiovascular disease (CVD) mortality in the Asia Cohort Consortium.

Methods: In this prospective cohort study, pooled analysis was performed to evaluate the association between cardiometabolic diseases (hypertension, diabetes, ischemic heart disease, and stroke), multimorbidity, and all-cause and CVD mortality, including premature mortality, among participants from 11 Asian cohort studies.

Genome-wide association study reveals a novel tuberculosis susceptibility locus in multiple East Asian and European populations.

Background: Tuberculosis (TB) continues to be a leading cause of morbidity and mortality worldwide. Past genome-wide association studies (GWAS) have explored TB susceptibility across various ethnic groups, yet a significant portion of TB heritability remains unexplained.

Methods: We conducted GWAS in the Singapore Chinese and Vietnamese, followed by a comprehensive meta-analysis incorporating 4 independent East Asian datasets, resulting in a total of 11,841 cases and 197,373 population controls.

Development and validation of a risk prediction model for premenopausal breast cancer in 19 cohorts.

Background: Incidence of premenopausal breast cancer (BC) has risen in recent years, though most existing BC prediction models are not generalizable to young women due to underrepresentation of this age group in model development.

Methods: Using questionnaire-based data from 19 prospective studies harmonized within the Premenopausal Breast Cancer Collaborative Group (PBCCG), representing 783,830 women, we developed a premenopausal BC risk prediction model. The data were split into training (2/3) and validation (1/3) datasets with equal distribution of cohorts in each.

Association between socioeconomic position and lung cancer incidence in 16 countries: a prospective cohort consortium study.

Background: Studies have reported higher lung cancer incidence among groups with lower socioeconomic position (SEP). However, it is not known how this difference in lung cancer incidence between SEP groups varies across different geographical settings. Furthermore, most prior studies that assessed the association between SEP and lung cancer incidence were conducted without detailed adjustment for smoking.

Nuclear regulatory disturbances precede and predict the development of Type-2 diabetes in Asian populations.

To identify biomarkers and pathways to Type-2 diabetes (T2D), a major global disease, we completed array-based epigenome-wide association in whole blood in 5,709 Asian people. We found 323 Sentinel CpGs (from 314 genetic loci) that predict future T2D. The CpGs reveal coherent, nuclear regulatory disturbances in canonical immune activation pathways, as well as metabolic networks involved in insulin signalling, fatty acid metabolism and lipid transport, which are causally linked to development of T2D.

Predictive Capabilities of Polygenic Scores in an East-Asian Population-based Cohort: The Singapore Chinese Health Study.

Background: Existing polygenic scores (PGS) are derived primarily from studies performed in European populations. It is still unclear how these perform in improving risk predictions in East-Asians.

Methods: We generated 2,173 PGSs from 519 traits and assessed their associations with 58 baseline phenotypes in the Singapore Chinese Health Study (SCHS), a prospective cohort of 23,622 middle-aged and older Chinese residing in Singapore.

Rheumatoid arthritis and subsequent fracture risk: an individual person meta-analysis to update FRAX.

Unlabelled: The relationship between rheumatoid arthritis (RA) and fracture risk was estimated in an international meta-analysis of individual-level data from 29 prospective cohorts. RA was associated with an increased fracture risk in men and women, and these data will be used to update FRAX®.

Introduction: RA is a well-documented risk factor for subsequent fracture that is incorporated into the FRAX algorithm.

The Association of Physical Function and Physical Performance With DNA Methylation Clocks in Oldest-Old Living in Singapore-The SG90 Cohort.

Deoxyribonucleic acid (DNA) methylation (DNAm) clocks estimate biological age according to DNA methylation. This study investigated the associations between measures of physical function and physical performance and 10 DNAm clocks in the oldest-old in Singapore. The SG90 cohort included a subset of community-dwelling oldest-old from the Singapore Chinese Health Study (SCHS) and Singapore Longitudinal Ageing Study (SLAS).

Incense Use and the Risk of Chronic Limb-Threatening Ischemia Among Middle-Aged and Older Adults in the Singapore Chinese Health Study.

Background: Epidemiologic studies have shown that daily exposure to incense smoke is associated with greater risk of cardiovascular mortality, which suggests that chronic exposure to incense could be linked to atherosclerosis. We studied the association between home incense use and the risk of chronic limb-threatening ischemia (CLTI), the most severe outcome of peripheral arterial disease.

Methods: We used data from the Singapore Chinese Health Study, which recruited 63,257 Chinese participants 45-74 years old from 1993-1998.

Relationship between handgrip strength and timed up-and-go test on hospitalization costs in older adults: a population-based study.

Background: Weak handgrip strength and slow timed up-and-go (TUG) time are known risk factors for hospitalization among older adults; however, few studies have investigated the relationships between these physical tests and future hospitalization costs.

Methods: We used data from 13,613 participants in the population-based Singapore Chinese Health Study who underwent assessment for handgrip strength and TUG time at a mean age of 74 years. Hospitalization costs for the subsequent year, among those who survived for at least one year thereafter, were ascertained via linkage with administrative healthcare finance data.

Reproductive factors and risk of epithelial ovarian cancer: results from the Asia Cohort Consortium.

Background: There are scarce data on risk factors for epithelial ovarian cancer (EOC) in Asian populations. Our goal was to advance knowledge on reproductive -related risk factors for EOC in a large population of Asian women.

Methods: This study used pooled individual data from baseline questionnaires in 11 prospective cohorts (baseline years, 1958-2015) in the Asia Cohort Consortium.