# Project 1 - Cognitive Function and Dementia

> **NIH NIH P01** · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · 2024 · $1,249,672

## Abstract

Project 1: Cognitive Function and Dementia—Abstract
The greatest impact of Alzheimer’s disease and related dementias (ADRD) is likely to be experienced in low-
and middle-income countries (LMICs). Sub-Saharan Africa, in particular, is projected to encounter a dramatic
increase in dementia prevalence and there is a growing need for rigorous population-based studies of ADRD in
this region. Health, Aging and Dementia in South Africa: A Longitudinal Study (HAALSI) addresses core
issues in dementia epidemiology in older South Africans. We implement measures harmonized with the global
Health and Retirement Study (HRS) and Harmonized Cognitive Assessment Protocol (HCAP) networks to
enable cross-national comparisons of dementia and its risk factors. Project 1 (Cognitive Function and
Dementia) leverages our deeply phenotyped HAALSI Agincourt cohort to identify causal pathways underlying
cognitive trajectories and applies well-validated neuropsychological assessments to a nationally representative
sample. These data will provide the first national estimates of dementia prevalence in South Africa. We do this
through tightly coordinated work across four overlapping cohorts. Our original HAALSI Agincourt cohort
comprised 5059 respondents ≥40 years of age, for whom we collected three waves of data; this renewal will
add two additional waves. HAALSI-HCAP Agincourt (n≈700) is an enriched subcohort that adds detailed
neuropsychological testing, neuroimaging, and blood biomarkers of ADRD; this renewal adds one additional
wave of HAALSI-HCAP Agincourt (wave 3). We propose to field a new, nationally representative study of 4500
men and women (plus partners) and a HAALSI-HCAP National survey (n≈624). Project 1 has 3 aims. Aim 1
focuses on characterizing the incidence and progression of mild cognitive impairment (MCI) and dementia in
relation to neurodegeneration and ADRD neuropathology in the enriched Agincourt-HCAP cohort. We examine
longitudinal change in magnetic resonance imaging (MRI) markers of brain aging and incorporate plasma
markers of ADRD (i.e., Ab, p-tau, NfL, GFAP) to assess associations with dementia symptoms. In Aim 2, we
refine and validate the HAALSI Global Cognitive Screen, HAALSI-HCAP, and HAALSI dementia algorithms for
South African nationwide surveys of dementia. We collaborate with Project 4 to conduct a baseline National
HAALSI-HCAP wave to generate national prevalence estimates for dementia and MCI. In Aim 3, we examine
the impact of social factors, including novel indicators of educational quality and social connection on
participants’ cognitive function and change trajectories. We explore informal educational experiences of special
relevance in the context of rapid social changes in South Africa, including self-taught literacy and effects of
children’s educational attainment on cognition in older parents. Optimizing all four cohorts (HAALSI Agincourt,
HAALSI-HCAP Agincourt, HAALSI National, HAALSI-HCAP National) we identify distinct biologi...

## Key facts

- **NIH application ID:** 10843296
- **Project number:** 5P01AG041710-10
- **Recipient organization:** HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH
- **Principal Investigator:** LISA F BERKMAN
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $1,249,672
- **Award type:** 5
- **Project period:** 2013-09-15 → 2028-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10843296

## Citation

> US National Institutes of Health, RePORTER application 10843296, Project 1 - Cognitive Function and Dementia (5P01AG041710-10). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10843296. Licensed CC0.

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