A comprehensive study to better understand changing demographics in Kenya and the resulting pressures on the country’s health system has received a multi-million dollar grant from the National Institutes of Health.
The Longitudinal Study of Health and Ageing in Kenya (LOSHAK) is a collaboration between the Department of Population Health at Aga Khan University (AKU) in Kenya and the University of Michigan (U-M) Institute for Social Research (ISR). The project received enabling support from the U-M Center for Global Health Equity and AKU’s Medical College, East Africa. The study is co-led by Joshua Ehrlich, the Paul R. Lichter Research Professor of Ophthalmology and Visual Sciences and a Research Associate Professor at the ISR, and Dr Anthony Ngugi, Chair of AKU’s Department of Population Health and Associate Dean for Research, East Africa.
“Thanks in part to improved health services and access, life expectancy in Kenya is increasing,” said Ehrlich, MD, MPH. “The irony is that these trends create new challenges for the very healthcare and economic systems that enabled them. Now, there is a need to adapt and innovate.”
While sub-Saharan Africa currently has one of the world’s youngest populations, the proportion of older adults is rising faster than anywhere else, thanks to increased life expectancy and the growing use of contraceptives and family planning services. By 2050, the continent’s share of people aged 60 and older is expected to nearly triple. In Kenya, where LOSHAK is focused, the number of adults aged 60 and older is projected to increase fourfold in the next 30 years.
The five-year, $23.6 million grant will be allocated between AKU and U-M. This will enable Ehrlich and Ngugi to survey thousands of Kenyans to better understand drivers of health and economic wellbeing in later life, as well as the long-term implications of emerging population trends.
“These demographic shifts will stress economic systems and create new demands for healthcare delivery, from elder care to chronic disease management and cancer treatments,” said Dr Ngugi. “Looking ahead, policymakers will need the best possible data to understand and care for LMIC populations that look much different from those typically seen today.”
At the heart of LOSHAK are two complementary surveys, each designed to align with established international research networks. The first, a Core survey, will target roughly 6,500 Kenyans aged 45 and older throughout the entire country. It will gather a range of health, social, and economic information. The survey will be deployed in more than a dozen languages, reflecting the country’s linguistic diversity. It is intended to harmonize with a global family of similar aging studies modeled after the U.S. Health and Retirement Survey.
Nested within the Core survey is a second study of about 2,300 individuals in the Coast region of Kenya aged 65 and older. This study will focus on identifying risk factors for cognitive impairment, Alzheimer’s disease, and related conditions. This cognitive survey follows the Harmonized Cognitive Assessment Protocol (HCAP), connecting it to an international network of comparable health studies.
Finally, the research team plans to incorporate environmental and physical activity data from wearable devices, as well as biomarker data from collected blood samples, checking for signs of inflammatory diseases and other chronic health conditions. The award will allow the team to establish a long-term survey cohort, laying the foundation for future studies to examine other dimensions of population aging.
All of the information gathered through LOSHAK will be publicly available to researchers for comparison alongside harmonized studies around the world, providing insights to academics, government officials, and policymakers across the African continent and beyond. Because chronic diseases, dementia, and caregiving pressures are nearly universal, the project’s impact is not necessarily confined to Kenya—or even sub-Saharan Africa—but could inform care anywhere, including in the United States.
“Our ultimate goal is to turn data into action—helping to shape health and economic systems that are ready to care not just for today’s population, but for older adults of the future too, no matter where they live,” said Dr Ngugi.
