Late life learning, dementia, and overall health in underresourced settings: an investigation of the University for Seniors in Beirut, Lebanon

Abstract

AbstractBackgroundIdentifying modifiable factors that reduce Alzheimer’s disease and related dementias (ADRD) risk is a global public health priority. Several key social determinants of ADRD, such as years of education, are completed earlier in life, and thus are unamenable to change in older age. Evidence on the protective benefits of engaging in cognitively stimulating activities suggests that late life learning (“LLL”, non‐formal educational activities outside formal credentialed learning) may provide a unique window of opportunity, in older age, to mitigate ADRD risk by providing prospects for intellectual stimulation and social engagement. Yet, studies assessing assessed the benefits of LLL are scarce. Evaluations of cognitive and social benefits for LLL are particularly relevant for low‐resourced settings, where opportunities for engaged aging are limited.MethodWe designed a prospective cohort study (the LLL and Cognition 3LC study), capitalizing on an established and ongoing LLL program at the American University of Beirut, The U niversity f or S eniors (UfS). The UfS has been running for over 11 years, allowing to assess shorter‐ and longer‐term LLL influences on cognitive and overall health. Living in Lebanon, our population of older adults have endured multiple lifecourse and recent adverse psychosocial exposures. Our project will also examine the role of LLL in older age in mitigating the impacts of earlier psychosocial adversities on health.ResultOur project is embedded within a capacity building program and close collaborations between researchers in the US and Lebanon, providing an infrastructure for research on dementia and psychosocial disparities in Lebanon and the region. We aim to recruit 500 previously enrolled UfS participants, 200 newly/prospectively enrolled UfS participants, and 700 age‐ and sex‐matched non‐UfS‐participating community residents (Figure 1). We plan to conduct cognitive assessments at baseline and a follow‐up visit using cognitive batteries designed aligned with the Harmonized Cognitive Assessment Protocol (HCAP). For a formal program evaluation of LLL on cognition and related outcomes, we will implement advanced analytical techniques (e.g., difference‐in‐difference estimation) (Figure 2).ConclusionOur project aims to build a longitudinal cohort study, together with research and infrastructure capacities, to delineate LLL opportunities for dementia prevention in Lebanon and neighboring countries.