Project Grant R21AG077042

LONGITUDINAL STUDY OF HEALTH AND AGEING IN KENYA (LOSHAK) - THE PROPOSED PROJECT AIMS TO BUILD THE INFRASTRUCTURE NEEDED TO SUCCESSFULLY FIELD THE LONGITUDINAL STUDY OF HEALTH AND AGEING IN KENYA (LOSHAK), A POPULATION-BASED COHORT STUDY OF ADULTS AGE =45 YEARS IN KENYA. THIS WILL BE A NEW STUDY IN THE HEALTH AND RETIREMENT STUDY (HRS) NETWORK OF HARMONIZED STUDIES ON AGING. KEY FOCUS AREAS OF LOSHAK WILL INCLUDE ALZHEIMER'S DISEASE AND RELATED DEMENTIAS (ADRD), MENTAL HEALTH, THE HEALTH AND ECONOMIC IMPACTS OF CLIMATE CHANGE AND AIR POLLUTION, AND FACTORS INFLUENCING LATE-LIFE ECONOMIC WELL-BEING. KENYA CURRENTLY HAS A RELATIVELY YOUNG POPULATION, BUT IS POISED TO EXPERIENCE VERY RAPID AGING OF ITS POPULATION OVER THE NEXT 30 YEARS. ACCORDINGLY, IT IS VITALLY IMPORTANT TO BEGIN STUDYING BOTH POPULATION-LEVEL TRENDS, AS WELL AS INDIVIDUAL AGING TRAJECTORIES IN ORDER TO CHARACTERIZE RISK FACTORS FOR HEALTH, DISABILITY, AND WELL-BEING IN THE KENYAN CONTEXT. IMPORTANTLY, THERE IS A MAJOR GAP IN POPULATION-LEVEL DATA ON AGING IN SUB-SAHARAN AFRICA, AND LOSHAK WILL BE ONLY THE SECOND STUDY IN THE HRS NETWORK FROM THE REGION. IN ORDER TO CARRY OUT THE PROPOSED INFRASTRUCTURE DEVELOPMENT AIMS, WE WILL LEVERAGE OUR STUDY TEAM'S ONGOING EPIDEMIOLOGIC SURVEILLANCE PLATFORM, THE KALOLENI/RABAI COMMUNITY HEALTH AND DEMOGRAPHIC SURVEILLANCE SYSTEM (KRHDSS) IN COASTAL KENYA, WHICH INCLUDES MORE THAN 14,000 INDIVIDUALS AGE =45 YEARS. IN THIS APPLICATION WE PROPOSE THE FOLLOWING AIMS: 1) TO ADAPT AND VALIDATE EXISTING HRS NETWORK MEASURES AND NEW SURVEY AND DATA COLLECTION PROTOCOLS (MOLECULAR BIOMARKERS, PHYSIOLOGICAL MEASURES) WITHIN THE KRHDSS; 2) TO DESIGN WAVE 1 OF LOSHAK, INCLUDING A SAMPLING STRATEGY TO DRAW A REGIONALLY-REPRESENTATIVE PROBABILITY SAMPLE; AND 3) TO DEVELOP A LONG-TERM STRATEGIC PLAN FOR EXPANSION TOWARDS A NATIONALLY-REPRESENTATIVE PANEL STUDY OF AGING IN KENYA FOR WAVE 2 OF LOSHAK. THE KRHDSS PLATFORM WILL ENABLE US TO EFFICIENTLY RECRUIT AND ENROLL PARTICIPANTS AND WILL CONTRIBUTE TO OUR SUCCESS CARRYING OUT THESE AIMS. THROUGHOUT THE INFRASTRUCTURE DEVELOPMENT PROCESS, WE WILL WORK CLOSELY WITH THE HRS AND THE HRS SISTER STUDIES NETWORK IN ORDER TO MAXIMIZE COMPARABILITY WITH THE MEASURES AND PROCESSES (E.G., TRAINING IN HRS INTERVIEW ADMINISTRATION, USE OF COMPUTER-ASSISTED PERSONAL INTERVIEWING SOFTWARE, DATA PROCESSING, ETC) USED IN OTHER HRS NETWORK STUDIES. THUS, LOSHAK WILL ULTIMATELY PROVIDE KEY POPULATION-BASED AND COMPREHENSIVE MEASURES ON HEALTH AND ECONOMIC WELL-BEING FROM MID- TO LATE-LIFE. THESE DATA WILL BE HARMONIZED IN ORDER TO ENABLE CROSS-NATIONAL COMPARISONS WITH HIGH-INCOME AND OTHER LOW- AND MIDDLE-INCOME COUNTRIES, THEREBY EXPANDING OPPORTUNITIES TO UNDERSTAND HEALTH AND AGING IN A GLOBAL CONTEXT.