A groundbreaking collaboration to better understand changing demographics — and the resulting pressures on health systems — has received a multi-million-dollar grant from the National Institutes of Health.

The Longitudinal Study of Health and Ageing in Kenya, or LOSHAK, is a collaboration between the Department of Population Health at Aga Khan University in Nairobi and the University of Michigan Institute for Social Research, with the goal of expanding the global repository of available research data on health and aging.

The effort 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 his collaborator, Anthony Ngugi, associate professor and chair of the AKU Department of Population Health and associate dean for research in the Medical College in East Africa.

“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,” Ehrlich said. 

LOSHAK received enabling support from the AKU Medical College as well as the U-M Center for Global Health Equity.

“Studies like this not only expand our understanding of health and aging globally, but also create valuable opportunities to benchmark U.S. health outcomes against multiple international settings. The insights gained will help shape better health and economic systems here at home as well as abroad,” said Akbar K. Waljee, the Leslie D. Yamada and Tachi Yamada M.D. Director of the U-M Center for Global Health Equity, assistant dean of global health research, and Lyle C. Roll Professor in the departments of Learning Health Sciences and Internal Medicine in Michigan Medicine.

Rapidly changing demographics make sub-Saharan Africa an ideal place to study aging. While the region 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 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 60 and older is projected to increase fourfold in the next 30 years.

“Thanks in part to improved health services and access, life expectancy in Kenya is increasing. 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,” Ehrlich said.

The five-year, $23.6 million grant will be allocated between AKU and U-M, enabling Ehrlich and Ngugi to shed light on the long-term implications of emerging population trends by surveying thousands of Kenyans.

At the heart of LOSHAK are two complementary surveys, each designed to align with established international research networks. The first “Core” survey will target roughly 6,500 Kenyans age 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 multilinguistic country. It is intended to harmonize with a global family of similar aging studies modeled after the U.S. Health and Retirement Study.

Nested within the Core survey is a second study of about 2,300 individuals in the Coast Region of Kenya age 65 and older, focused on identifying risk factors for cognitive impairment, Alzheimer’s disease and related conditions. This cognitive survey follows the Harmonized Cognitive Assessment Protocol , connecting it, too, 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.

“Demographic shifts stress economic systems and create new demands for healthcare delivery, from elder care to chronic disease management and cancer treatments,” Ngugi said. “Looking ahead, policy makers will need the best possible data to understand and care for populations that look much different from those typically seen today.”