The Longitudinal Study of Health and Ageing in Kenya (LOSHAK): A Population study of Health, Wellbeing, Economics, and AD/ADRD in Older Kenyan Adults - Kenya’s population is aging rapidly, with the number of adults aged 60 and older projected to increase 4- fold in the next 30 years. However, there is little population level data from Kenya or neighboring countries to inform economic, policy and public health planning. Our team seeks to address this gap through the development of the Longitudinal Study of Health and Ageing in Kenya (LOSHAK-Core), which joins a growing global network of harmonized panel studies of health, economics, and aging modelled on the U.S. Health and Retirement Study (HRS). Likewise, the LOSHAK-Harmonized Cognitive Assessment Protocol (LOSHAK-HCAP) will join a group of more than 15 HCAP studies around the world on epidemiology and risk factors for cognitive impairment and Alzheimer’s disease and related dementias (AD/ADRD). Our team’s LOSHAK feasibility and pilot studies (R21AG077042) demonstrate our ability to collect and analyze complex survey data, blood-based biomarkers, and data from wearable sensors in older Kenyan adults. Wave 1 of the LOSHAK-Core and -HCAP studies will be led by the University of Michigan/Aga Khan University team in close collaboration with the Kenya Ministry of Health, Kenya National Bureau of Statistics (KNBS), and Kenya Medical Research Institute. The long-term objective of LOSHAK is to generate longitudinal population representative data on health, economics, wellbeing, and AD/ADRD among older Kenyans. LOSHAK-Core will be nationally representative of Kenyans aged 45 and older, with a sample size of 6,580. LOSHAK-HCAP will be representative of Kenyans aged 60 and older in the Coast Region (6-county administrative designation), with a sample size of 2,375. We will use KNBS sampling frames that are based on the national census and have been used in prior national studies. In Aim 1, we will collect Wave 1 LOSHAK-Core data in 16 regional ethnic languages. The survey will include key HRS health and economic domains and innovative modules, collect data using wearable activity and air pollution monitors, and assess anthropometrics. We will also collect whole venous blood to assay biomarkers of inflammation, chronic health conditions, and AD/ADRD, as well as to store blood for future analyses. In Aim 2, we will collect data on cognitive health and AD/ADRD using the HCAP and will estimate the prevalence of AD/ADRD in the Coast Region, while leveraging overlap between the Core and HCAP samples to make national estimates. In Aim 3, we will make data publicly available to the scientific community for comparison with other HRS/HCAP studies and disseminate findings to key stakeholders. In Aim 4, we will engage in capacity strengthening across all components of LOSHAK, consistent with our commitment to accelerate the pace and rigor of aging research in Kenya. LOSHAK will make vital contributions, providing harmonized population representative data on individual, policy, and structural risk and resilience factors that influence late-life health and economic wellbeing in Kenya.
