Validating Community for Successful Ageing (ComSA) BioPsychoSocial Risk Screener Version II (BPS-RS II) with Diverse Multi-Ethnic Senior Populations in Singapore: A Mixed-Methods Study

Background: Accurately assessing biopsychosocial risk and vulnerability are the building blocks for better interventions and tailoring care for older people.

Methods: Building on the previously published Community for Successful Ageing (ComSA) BioPsychoSocial Risk Version I Screener (BPS-RS I), we report a re-specified version (BPS-RS II) derived from interviews with older people (n = 40) in Singapore. A cross-sectional survey (n = 1,107) and Factor Analysis (FA) were used to identify items for BPS-RS II. Associations with health-related and quality of life (QoL) and comparisons to Version I were examined.

Results: Fourteen questions generated from the qualitative findings clustered above the stipulated Kaiser–Meyer–Olkin (KMO) value of greater than 0.5. FA retained the BPS three factor structure. Items in the B domain were largely consistent with Version I, though new items in the P and S domains were identified. Adjusted multi-variate regression analyses replicated additive dose response effects found in BPS-RS I, with smoother gradients and narrower Confidence Intervals (CIs). Stronger associations with Length of Hospital Stay and QoL were detected in BPS-RS II compared to BPS-RS I for participants with BPS risk consisting of having ‘overwhelming problems’. The relationship between this category and poor QoL was particularly evident (OR of 39.20, 95% CI: 37.73–40.66, p < 0.01) compared to no BPS risk.

Conclusions: Using BPS-RS II over I is recommended for biopsychosocial risk assessment and stratifying older people to interventions for population health management. The updated tool is theory-based, culturally sensitive to multi-ethnic contexts in Singapore, and shows improved associations with health-related outcomes, and strong associations with QoL.

SOURCE: BMC Geriatrics

DOI: https://doi.org/10.1186/s12877-025-06055-9

AUTHORS: Aw S, Shiraz F, Vrijhoef HJM, Jiajing KX, Yin JD, Ng WC, Lim ZZB, Keong POC, Koh GCH, Hildon ZJ.