Meet our GERI Researchers | Dr Tou Nien Xiang
6 December 2023
Dr Tou Nien Xiang is a Research Fellow at GERI. He obtained his PhD in sports and exercise science from Nanyang Technological University, Singapore. His current research focuses on the uptake of physical activity in older adults to promote active ageing. He is also a data enthusiast and is passionate about using data to gain insights and solve problems.
We speak to Dr Tou about why he believes exercise is medicine that transcends age and health barriers, and his ongoing work with community partners and practitioners to identify and tackle real-world challenges in ageing.
Your academic background lies in sports science. How did you come into the study of ageing issues and why does this field interest you?
Research is like solving a giant jigsaw puzzle, and as a researcher, I enjoy answering questions, testing hypotheses and solving problems through empirical evidence. Ultimately, I hope to make a meaningful impact and contribution to society through my work.
Given the global problem of physical inactivity and its adverse effects on health outcomes, I am particularly interested in leveraging my background in exercise and sports science to make a meaningful contribution in promoting physical activity in our population. Particularly, promoting physical activity in older adults is of paramount importance. I strongly believe that exercise is medicine, and this is especially true when it comes to ageing. Ageing is a marathon that we are all running, and I hope my research can help everyone stay ahead in the race.
Your research activities with GERI have certainly been diverse—for example, from traversing various Senior Activity Centres in the community, to conducting evidence synthesis on dementia to inform policymakers. What have you found rewarding about doing such community-based and health policy research?
It is important for research findings to be translated into practice and policy to make an impact. Through my work in GERI, I recognise the importance of engagement with key stakeholders to achieve this. Working closely with community partners helps me to better understand and identify real-world problems that need to be addressed. Personally, I also believe that health policies should be evidence-based. While I am cognisant that policymaking is multifaceted, I hope my contribution through my research plays a part in the process.
Although it can be challenging at times, the most rewarding part of such work is learning how our research has made a positive impact on the lives of older adults. For example, we recently conducted a study on the implementation of an exercise intervention for older adults based on Baduanjin, a form of traditional Chinese Qigong exercise. It was heartening when older adults who took part in this study gave me feedback that they enjoyed the exercise programme, which our study has found to be a feasible and safe form of exercise for frail older adults in our community.
You recently co-authored a journal paper that affirms the potential benefits of using simple exercise equipment, like weights, to improve strength and balance among the oldest-old (>79 years old) and frail. Why focus on this particular subgroup of older adults, for whom physical activity often takes a backseat due to other health stressors?
The lifespan of humans is increasing, and many older adults are living past 80 years of age. In fact, some people suggest that 80 is the new 60! As lifespan increases, increasing the healthspan – or years lived in good health – of this group of oldest-old adults is also critical. While it may be inevitable that frailty, sarcopenia* or disability sets in with age, we can delay such phenomena with healthy lifestyle behaviours such as exercising.
Frailty and/or old age are not contraindications to exercise, but reasons to do so. Our review results suggest that this specific older population group could still reap benefits from exercise interventions involving minimal equipment. Thus, this echoes the need for older adults to continue exercising regardless of age and conditions to promote healthy ageing.
* Frailty refers to an overall loss in physical and health reserves that increases a person's vulnerability, while sarcopenia is a condition that specifically refers to a loss of muscle mass and strength.
More generally, given your work in this area, what would you say to an older family member who is apprehensive or skeptical about exercise?
This may sound cliché, but the saying does hold true: The best time to start was yesterday, and the next best time is now! Coming back to what I said earlier, I strongly believe that exercise is medicine because it is anti-ageing. Currently, there are no approved drugs to treat age-related conditions such as frailty and sarcopenia. However, existing empirical evidence has all pointed towards exercise as a robust intervention to maintain and improve functional independence in older adults. It is never too late or too old to start. Regardless of our age and health conditions, most of us can always reap the numerous health benefits of exercise and physical activity.
Your work at GERI has allowed you to work closely with faculty and practitioners who are domain experts in areas ranging from rehabilitation medicine, frailty to population health. How has that been like?
Prior to joining GERI, I came from a more academic research background in which I mostly collect data through experiments in laboratory settings. Special mention to Associate Professor Wee Shiou Liang, Associate Professor Ng Tze Pin and Dr Charlene Lau for acquainting me with community-based research. Since then, it has influenced my perspective towards research, and I learnt to see impact beyond the typical scientific publications.
I am privileged to work together with colleagues and faculty members from diverse backgrounds in GERI. Each of them brings their unique expertise and perspectives to the table. Ageing and health issues are often multifaceted; for example, frailty alone could be differentiated across physical, cognitive and social forms. Such diversity fuels innovation and stimulates us to think about research questions through different lenses. I am also thankful to learn many things in domain knowledge and methodologies in the process.
What do you like to do in your spare time that helps protect against functional decline?
My motivation to be a researcher stems from my interest to work with data. Outside of work, I enjoy learning statistics, data science and R programming language. The best way to do so is by trying to apply what I learn. I maintain a personal blog in which I document some of my personal data projects and I also write about coding and sports science-related topics. I hope this helps me in mitigating cognitive decline! Physical activity-wise, I am an avid runner. I enjoy running long distances while tuning in to a good podcast. It is a great way to learn something new and pump your heart at the same time!