Jockey Club Institute of Ageing: the 2014 Jockey Club donation and the "age-friendly city" vision

One-line positioning: The Chinese University of Hong Kong's Jockey Club Institute of Ageing (CUHK Jockey Club Institute of Ageing) was formally established in August 2014 with an HK$12 million donation from The Hong Kong Jockey Club Charities Trust^※ (covering the first five years of operating costs), with the core mission of "making Hong Kong an age-friendly city in the world." Integrating medicine, nursing, psychology, architecture, social work and other disciplines, it is the institutional hub for gerontology research within the CUHK Faculty of Medicine.

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# Why was the Institute founded in 2014?

The pace of Hong Kong's population ageing dictated the urgency of a policy response. According to the population data page of CUHK's S.H. Ho Centre for Gerontology and Geriatrics^※, the proportion of the population aged 65 or above was projected to rise from 11.7% in 2003 to 27% by 2033^※ (source: Hong Kong Census and Statistics Department mid-year population projections, base year 2003). In other words, roughly one in four people in Hong Kong would then be elderly, with the median age climbing from 38 to 49. Meanwhile, Hong Kong had already joined the world's top three^※ in life expectancy — a double challenge, as a very old population brings combined demands on both medical care and community support.

It was against this backdrop that the Hong Kong Jockey Club Charities Trust took the initiative in August 2014, donating HK$12 million to establish the Jockey Club Institute of Ageing jointly with CUHK. The gift was one of two major projects the Club funded at CUHK that year — the other, announced the same day, was a donation of HK$1.3 billion^※ to support the construction of a CUHK teaching hospital, which the Club's official press release described as "the largest contribution ever made by the Club to a single medical project in Hong Kong." That self-financed private teaching hospital became the CUHK Medical Centre, whose development is traced separately in Faculty of Medicine — structure, teaching hospitals and research strengths.

It is worth noting that the two sums were announced in the same press release on the same day, pointing to a combined investment in CUHK's medical landscape: hardware at one end (the teaching hospital) and software and knowledge at the other (gerontology research). Compared with HK$1.3 billion, HK$12 million is a rounding error — yet the problem the Institute was charged with, how to make a rapidly ageing city "age well," was given equal billing with the new hospital in the Club's own framing. From the outset, then, the Institute was never conceived as a mere laboratory but as an intermediary institution connecting medical hardware, community services and public policy.

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# Who is Professor Jean Woo, and why did she become founding Director?

According to the Institute's official "About Us" page^※ and the 2014 official press release^※, Professor Jean Woo was appointed the Institute's founding Director. Her full title is "Emeritus Professor, Department of Medicine and Therapeutics, and Henry G Leong Research Professor of Gerontology and Geriatrics" at the CUHK Faculty of Medicine.

Before taking up the directorship, Professor Woo had already been the academic lead on another Club-funded flagship gerontology initiative — the CADENZA programme ("CADENZA: A Jockey Club Initiative for Seniors"). Led by the CUHK School of Nursing, CADENZA was a territory-wide, multi-disciplinary gerontology education and community project providing training to nursing and social welfare professionals, family carers of older people, and the public. The Institute's establishment can be seen as the institutionalisation of CADENZA's accumulated gerontology resources and research energy at a higher level.

Her academic record gave the appointment ample weight. According to CUHKUPDates, the University's Communications and Public Relations Office publication^※, Woo graduated from the University of Cambridge in 1974, moved into research after completing her medical training in the United Kingdom, and joined CUHK's Department of Medicine in 1985, where she was responsible for developing geriatric medicine teaching and clinical services. She was appointed Professor of Medicine in 1994. Her research has long centred on "frailty," a core concept in geriatric medicine — the state of accumulated physiological decline and diminished resilience that comes with age. On how to measure frailty and how to reverse it, she and her team have done extensive work, including comparing the "frailty phenotype" and "frailty index" — the two dominant measurement approaches — in predicting death and disability, and validating the simple FRAIL scale for screening community-dwelling older adults. This research line, from clinical scales to community interventions, would become the methodological bedrock of many of the Institute's later community projects.

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# What is the Institute's mission and interdisciplinary structure?

According to the Institute's background page^※, the Institute states its vision explicitly as "to make Hong Kong an age-friendly city in the world," pursued through "research, policy advocacy, community outreach and knowledge transfer to promote a comprehensive active ageing strategy." This framing puts academic research on the same footing as policy practice and community delivery — a deliberate departure from a purely laboratory-oriented institution.

The Institute's interdisciplinary architecture is laid out in detail on its organisational structure page^※. It houses multiple research and collaborating centres, drawing Fellows from the following disciplines:

The Deputy Directors are Professor Helene Fung of the Department of Psychology and Professor Timothy Kwok of the Department of Medicine and Therapeutics. This arrangement, placing medicine and the social sciences side by side, is a comparatively "broad-spectrum interdisciplinary" model among Hong Kong's gerontology research institutions.

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# What are the Institute's research priorities?

According to the Institute's "Research Strength on Ageing" page^※, the Institute consolidates CUHK's existing gerontology research base, with focus on the following thematic areas:

• Geriatric medicine and social psychology: CUHK's S.H. Ho Centre for Gerontology and Geriatrics has conducted related research since 1998^※, making it one of the Institute's earliest academic forerunners.
• Dementia research: advanced through the Jockey Club Centre for Positive Ageing.
• Sarcopenia and osteoporosis: research on the effects of exercise and nutrition interventions on sarcopenia, plus programmes run through the Jockey Club Osteoporosis Care and Control Centre.
• Geriatric nutrition: research on the role of diet and other lifestyle factors in preventing common age-related chronic diseases.
• Gerontechnology: developing and promoting technological applications that support active ageing.
• Community end-of-life care: collaborating with the University of Hong Kong and others on the Jockey Club End-of-Life Community Care Project (JCECC).

On the policy research front, Professor Woo's team published an academic paper^※ in 2020 in the Journal of Nutrition, Health & Aging that systematically tracked changes in the Hong Kong Elderly Quality of Life Index (HKEQOL) across four domains between 2017 and 2020, showing that age-friendly city policies initially improved elder wellbeing but that social events in 2019 and the COVID-19 pandemic sent the composite score tumbling from 100.95 to 93.22 — a rare study in the Institute's output that presents, in data, the effects of both policy and social shocks. Mentioned here for the record, without further narrative.

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# Can frailty be reversed? What a controlled trial found

One of the Institute's signature outputs is a randomised controlled study that directly answers whether frailty can be reversed. According to a Faculty of Medicine press release^※, the team of Professor Jean Woo and senior research fellow Dr Ruby Yu designed the Multicomponent Frailty Prevention Programme (MFPP), implemented in 2017–2018 with the CADENZA Hub. It recruited 127 older adults in the "pre-frail" stage, averaging 62.2 years of age, randomly assigned to intervention and control groups.

The intervention itself was hardly elaborate: twice a week for 12 consecutive weeks, three things bundled together — aerobic and resistance exercise, computer-assisted cognitive training, and board games. This low-cost, drug-free combination produced striking results.

The findings were published in the Journal of the American Medical Directors Association (JAMDA). The significance of the trial goes beyond the numbers: it translated "active ageing" — a concept all too easily reduced to sloganeering — into an operational, replicable intervention that can be run from a community centre, and it validated the Institute's "research–community outreach–knowledge transfer" trinity in practice. The Institute has since rolled out frailty screening and prevention activities in the community on this basis, taking laboratory conclusions back to the older adults themselves.

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# How has the "Age-Friendly City" vision been put into practice?

The "Age-Friendly City" concept originates in the World Health Organization (WHO) framework, which emphasises the dual role of the built environment and social inclusion in healthy ageing. The Institute has translated this vision into concrete action through the following projects:

The AgeWatch Index and the Hong Kong Elderly Quality of Life Index (HKEQOL)

According to the Institute's AgeWatch page^※, the Institute has contributed to the global AgeWatch Index since 2014 and developed a locally adapted version. The global AgeWatch Index, constructed by HelpAge International, breaks a country's elder wellbeing into four domains — income security, health status, capability (employment and education), and enabling environment (social connections, physical safety, civic freedom and public transport). The Institute's work has been to feed Hong Kong's data into this framework, allowing the situation of Hong Kong's older people to be compared item by item with the rest of the world.

Hong Kong ranked 24th out of 97 countries and territories in the 2014 global AgeWatch Index^※ (overall ranking; source: Global AgeWatch Index 2014). Performance across the four domains was strikingly lopsided: "health status" ranked 9th and "enabling environment" 4th, both among the world's best, but "income security" came in at only 75th, dragging the total down. Professor Woo said at the time that Hong Kong's performance on health status and the social environment was "fairly good," but that there was still room to improve older people's psychological wellbeing and social connections. In the 2015 Index, Hong Kong rose to 19th. This structural diagnosis of "one strength, one weakness" would recur throughout the Institute's local assessments in the years that followed, becoming the core evidence base for its advocacy to government: what Hong Kong's older people most lack is not longevity or access to medical care, but financial security after retirement.

On top of the global Index, the Institute built a localised Hong Kong Elderly Quality of Life Index (HKEQOL). According to the 2020 academic paper^※, HKEQOL follows the four-domain structure of the global AgeWatch Index (income security, health status, capability, enabling environment), each domain containing multiple equally weighted indicators, with data drawn from two sources: objective government statistics, and annual telephone surveys of about 1,200 Hong Kong residents aged 50 and over. The Index takes 2017 as its base year, set at a total score of 100, with subsequent years expressed as percentage changes. This design gave Hong Kong's elder wellbeing, for the first time, a trackable continuous measure of annual fluctuation — it monitors not the success or failure of any single policy, but the "temperature" of the city's older population as a whole.

The WHO eight-domain framework

The key to understanding "age-friendly cities" is the WHO's eight assessment domains, proposed in 2007. The framework breaks "whether a city is friendly to older people" into individually measurable dimensions, covering both hardware and software. According to the Institute's age-friendly community assessment page^※, the eight domains are: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; communication and information; community support and health services; and civic participation and employment. The Institute's territory-wide assessments use these eight domains as a common yardstick, making cross-district and cross-year comparisons possible.

The Jockey Club Age-Friendly City Project

In 2015, The Hong Kong Jockey Club Charities Trust donated over HK$100 million^※ to lead the Jockey Club Age-Friendly City Project, commissioning four local gerontology research institutions — the CUHK Jockey Club Institute of Ageing, HKU's Sau Po Centre on Ageing in the Faculty of Social Sciences, PolyU's Institute of Active Ageing, and Lingnan University's Asia-Pacific Institute of Ageing Studies — to conduct baseline "age-friendliness" assessments of all districts in Hong Kong using the WHO eight-domain framework. The four institutions divided the districts between them; the CUHK Institute was responsible for surveys in several districts and the follow-up action support.

The project proceeded in two steps. The first was a pilot in eight districts^※ from July 2015 — Sha Tin, Tai Po, Central & Western, Wan Chai, Islands, Tsuen Wan, Kowloon City and Kwun Tong; the second extended the project to all 18 districts from January 2017, bringing in the remaining ten (Kwai Tsing, North, Sai Kung, Eastern, Southern, Wong Tai Sin, Tuen Mun, Yuen Long, Sham Shui Po and Yau Tsim Mong). At that point, a territory-wide baseline map of age-friendliness, measured on a consistent yardstick, was in place.

According to Jockey Club corporate news (May 2016)^※, the baseline surveys in the eight pilot districts in 2015–2016 interviewed more than 4,200 respondents. "Social participation" (55.6% positive ratings) and "transportation" (53%) scored highest, while "housing" (37.9%) and "community support and health services" (37.7%) most needed improvement — a hot-and-cold contrast that echoes the structural picture from the AgeWatch Index of Hong Kong having a strong "enabling environment" but weak "income security": Hong Kong's older people are doing reasonably well on social connection and getting around, with the shortfalls concentrated in housing costs, economic security and medical support. The research findings were handed to District Councils for use in three-year action plans, turning academic assessment directly into measures at the district governance level.

The Institute published a comprehensive book on the project, Strategies for Creating an Age-Friendly City: Hong Kong as a Case Study, providing an evidence base for policy advocacy; the project has also continued to publish thematic reports digging into improvement pathways for individual domains such as "communication and information."

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# Dementia and end-of-life care: how the Institute engages with "the two hardest ends"

If the age-friendly city agenda addresses "how to age well," then dementia care and end-of-life care address the two most difficult moments of old age. The Institute has实体 projects on both fronts.

Dementia: starting with Hong Kong's first integrated dementia care centre

The Institute advances its dementia research chiefly through the Jockey Club Centre for Positive Ageing (JCCPA). According to the Jockey Club's Charities page^※, JCCPA was established in 2000 as Hong Kong's first integrated dementia care centre^※, combining day care, family carer support, professional training and clinical research in one institution. It is at once a service provider and a field site where the Institute observes the real circumstances of dementia patients and their carers, yielding first-hand samples for scale validation and intervention design.

End-of-life care: the CUHK link in the Jockey Club End-of-Life Community Care Project

At the end of life, the Institute participates in the Jockey Club End-of-Life Community Care Project (JCECC). According to JCECC project materials^※, the project was funded by The Hong Kong Jockey Club Charities Trust with a donation of approximately HK$623 million, launched in 2016, and is a cross-professional, cross-organisational, cross-sectoral collaboration whose core goals are to improve the quality of end-of-life care in Hong Kong, strengthen the capacity of service providers, and raise public awareness of facing death. The project pays particular attention to the interface between the social care and medical systems — the gap through which terminally ill older adults and their families are most apt to fall.

The Institute's remit within the project is to work with the Hospital Authority to improve end-of-life care quality in the community and hospitals of the New Territories East cluster, focusing on strengthening the palliative care capabilities of healthcare professionals and helping patients and families face death prepared. The Institute is based at the Prince of Wales Hospital, which sits within the New Territories East cluster — a geographical alignment that allows clinical care, community services and research to close the loop within a single service network; the hospital's own history is covered separately in Prince of Wales Hospital and SARS.

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# How does the Institute connect with the CUHK Faculty of Medicine's gerontology tradition?

The Institute was not built from nothing; it continues more than two decades of gerontology work in CUHK's Department of Medicine. The S.H. Ho Centre for Gerontology and Geriatrics had been conducting research on geriatric medicine and social psychological issues as early as 1998^※. Professor Jean Woo's own academic career also started at that Centre, covering research on nutritional strategies for older people, the effects of the living environment on health, and the construction and application of active ageing and frailty indices — a body of work that laid the academic foundations for the Institute when it was established in 2014.

On the Jockey Club funding side, the Institute's lineage runs through the CADENZA programme. Funded by the Club and led by the School of Nursing, CADENZA was launched in 2007–2008; its name is the musical term for a cadenza — the virtuosic solo passage near the end of a piece — a metaphor for life remaining brilliant in old age. The programme centred on interdisciplinary education and training, delivering gerontology knowledge to nursing and social welfare professionals, family carers of older people, and the public across Hong Kong, and operated a community service hub, the CADENZA Hub, as its delivery platform. The frailty-reversal MFPP trial described above was run at the CADENZA Hub. The Institute's establishment in 2014 can be seen as the next step beyond CADENZA's educational programmes — institutionalising the research, scaling up policy advocacy, and stacking education, service and research into a fuller gerontology ecosystem.

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# What centres and project platforms sit under the Institute?

The Institute is not a single laboratory but an "umbrella" organisation that consolidates CUHK's existing gerontology units. According to the organisational structure page^※ and the research strengths page, its core integrated or affiliated platforms include:

The Fellowship system then links scholars across these platforms horizontally: Fellows come from departments of medicine, psychology, social work, public health, architecture and beyond, sharing projects and data through the Institute rather than working in silos. This two-tier structure of "physical centres plus cross-departmental Fellows" is the organisational basis for the Institute's broad-spectrum interdisciplinary operation.

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# Beyond research, how does the Institute reach ordinary citizens?

The Institute has written "knowledge transfer" into its mission, which means its output extends beyond papers and policy reports to projects that directly benefit older people and the public. According to the Institute's background page^※, this layer of work falls roughly into three strands.

First, lifelong learning for older adults. The Institute participates in CUHK's Elder Academy, bringing older learners onto campus to take courses, on the argument that learning itself is a way of resisting ageing and maintaining social connections — echoing the "capability" (education and employment) domain of the AgeWatch Index.

Second, public awareness education. The Institute has produced the "Wise Elder" ("智『耆』人") series for RTHK public television, translating professional knowledge of active ageing, dementia recognition and frailty prevention into accessible language for viewers that research reports could never reach.

Third, community technology applications. The Institute runs projects such as the Jockey Club Community eHealth Care Project (JC eHealth), bringing remote health management and gerontechnology into the daily lives of older people in the community — making technology a tool that supports "ageing in place" rather than a barrier to it.

These three strands, combined with the research and policy advocacy described above, complete the Institute's four-layer architecture of "research–advocacy–service–education." It also connects to the WHO's Decade of Healthy Ageing (2021–2030): in recent years the Institute has placed its age-friendly city assessments within this global action framework, setting Hong Kong's local work into a longer international agenda.

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# Major projects at a glance

The table below lists representative projects of the Institute. Source: Institute official website, consolidated^※.

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# Related reading

This article belongs to the 11-medical-hospital module. Related files:

• Faculty of Medicine structure and clinical departments
• Founding history of the Faculty of Medicine and its founding Dean
• Prince of Wales Hospital and SARS
• School of Chinese Medicine: one of Hong Kong's earliest Chinese medicine degree programmes, 1998

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