{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:10:00Z","timestamp":1788977400350,"version":"build-2803163510"},"posted":{"date-parts":[[2026,9,7]]},"group-title":"Epidemiology","reference-count":30,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"name":"National Institutes of Health (NIH) and National Institute on Aging","award":["R01AG069016"],"award-info":[{"award-number":["R01AG069016"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,9,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:p>The Middle East and North Africa (MENA) region is projected to experience the fastest growth in dementia burden globally, yet population-based data on cognitive aging remain scarce. We present the implementation and psychometric evaluation of a comprehensive cognitive assessment in the Lebanon Study on Aging and Health (LSAHA), the first large-scale, population-based study of cognitive aging and dementia in an Arab country.<\/jats:p>\n                <jats:p>We implemented a construct-centered adaptation of the Harmonized Cognitive Assessment Protocol (HCAP), integrating culturally-relevant and field-informed adaptation and implementation procedures. The battery was administered in a large, socioeconomically and educationally diverse sample of older adults in Lebanon (n=3,027). Confirmatory factor analyses (CFA) were used to evaluate psychometric performance.<\/jats:p>\n                <jats:p>CFA results demonstrated good to excellent model fit across general and domain-specific cognition. Cognitive scores showed expected trajectories across age, education, and subjective health and memory indicators. Findings were consistent with HCAP studies across multiple countries, supporting cross-national comparability.<\/jats:p>\n                <jats:p>This study establishes a foundational infrastructure for cognitive aging research in Lebanon and the broader Middle-East and North Africa (MENA) region and demonstrates the feasibility and value of adapting HCAP for underrepresented populations.<\/jats:p>","DOI":"10.64898\/2026.09.02.26362058","type":"posted-content","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T06:35:12Z","timestamp":1788849312000},"source":"Crossref","is-referenced-by-count":0,"title":["Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA)"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5035-0370","authenticated-orcid":false,"given":"Martine","family":"Elbejjani","sequence":"first","affiliation":[{"name":"Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut, 1107 2020 Lebanon"},{"name":"Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, 1107 2020 Lebanon"},{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalil","family":"El Asmar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2695-8079","authenticated-orcid":false,"given":"Monique","family":"Chaaya","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghia","family":"Sanjar","sequence":"additional","affiliation":[{"name":"Clinical Research Institute, Faculty of Medicine, American University of Beirut, Beirut, 1107 2020 Lebanon"},{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6400-7217","authenticated-orcid":false,"given":"Aya","family":"El Sammak","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2798-1836","authenticated-orcid":false,"given":"Kenneth M","family":"Langa","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and the Institute for Social Research, University of Michigan School of Public Health, Ann Arbor, MI 48109-2029"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0078-7010","authenticated-orcid":false,"given":"Stephen J","family":"McCall","sequence":"additional","affiliation":[{"name":"Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abla","family":"Sibai","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, 1107 2020 Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3020-826X","authenticated-orcid":false,"given":"Carlos","family":"Mendes De Leon","sequence":"additional","affiliation":[{"name":"Department of Global Health, Georgetown University School of Health, Washington, DC, 20057 USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"54368","reference":[{"key":"2026090910451674000_2026.09.02.26362058v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00249-8"},{"issue":"5","key":"2026090910451674000_2026.09.02.26362058v1.2","doi-asserted-by":"crossref","first-page":"e70207","DOI":"10.1002\/alz.70207","article-title":"Cognitive assessment tools for Arabic-speaking older adults: A systematic review","volume":"21","year":"2025","journal-title":"Alzheimers Dement"},{"key":"2026090910451674000_2026.09.02.26362058v1.3","unstructured":"Koettl-Brodmann J , Gomez Tamayo S , Morgandi M , Zeid R . 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