A Longitudinal Study of Egyptian Healthy Aging (Al-SEHA)

This project will implement A Longitudinal Study of Egyptian Healthy Aging (“AL-SEHA”) including the harmonized cognitive assessment protocol (HCAP) to measure the prevalence of Alzheimer’s disease and related dementias (AD/ADRD) in Egypt. It is modeled after the US HRS and member surveys and is aligned with several aspects of NIA’s mission, particularly “…the development of internationally comparative studies of physical, mental and cognitive health and harmonization efforts in different social, environmental, cultural, and economic contexts…” AL-SEHA fills a significant void in the international network of harmonized aging studies.

As a pivotal constituent of the Middle East and Africa, Egypt has an enormously diversified population, socioeconomically, genomically, and culturally. Egypt is characterized by a strongly SES-graded health and cognitive decline up to the stage of dementia, a large gender divide, particularly for elderly women, and looming challenges for older citizens due to environmental and climatic challenges potentially causing ADRD.

Despite advances, Egypt’s health and wellbeing landscape includes striking social and economic inequalities and inequities between men and women, old and young, urban and rural communities, and upper and lower Egypt. The project will inform issues of equity, gender, and climate concerns in a context that is new for the HRS-style aging surveys and their analyses of AD/ADRD.

While Egypt has a history of cross-sectional population surveys, AL SEHA will be the first nationally representative longitudinal study of aging in Egypt. This longitudinal dimension will fill a major gap and will provide a better understanding of the precursors and dynamics of physical, mental and cognitive health, including AD/ADRD, and the inequality and inequity in a large emerging economy that shape the SES-gradient of health.

It will offer unprecedented opportunities to delineate health, social and economic challenges and to develop policy recommendations for this and similar emerging countries and communities. AL SEHA will be administered to 20,000 individuals aged 50-years and older. It will provide a baseline and a first follow-up wave including HCAP as tested and contextually validated tool to measure cognitive status and to assess AD/ADRD prevalence in Egypt, a community module, geocoded and environmental data.

Three years of preparatory activities included a first pilot that built research capacities and demonstrated scholarly and policy interest and commitment; a second pilot funded by NIA that tested the representative sample design and demonstrated the feasibility of high quality fieldwork within planned time and budget; and a third NIA-funded pilot that deployed the HCAP instrument to screen for AD/ADRD. The studies demonstrated need, feasibility, and ability of the team to undertake the proposed work, and the securing of the essential partnership of the Institute of National Planning (INP), the support of the Ministries of Planning and Economic Development and of Health and the Survey of Health, Aging and Retirement in Europe.

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