The overall objective of this application is to investigate the role of stress-related experiences throughout the life-course in the development of Alzheimer’s disease and related dementias (ADRD). Many individuals and communities in the US experience prolonged periods of elevated stress and depression due to living in socially or economically unstable environments, yet the impact of such experiences in dementia risk is not well understood. A second objective is to investigate the personal care arrangements of older adults with dementia in a rapidly changing informal and formal care environment, leaving many older adults with unmet care needs. A second focus is on describing the care arrangements for older adults with dementia in a setting of dwindling formal and informal sources of care. These conditions affect many individuals and communities in the US, yet the impact of these exposures on ADRD risk and associated care needs later in life remain incompletely understood. To accomplish these objectives, we propose to develop and conduct a new population-based of middle-aged and older adults in Lebanon. Lebanon provides a unique setting to investigate the role of stressrelated experiences throughout the life-course due to the prolonged duration of civil strife and conflict in this country, starting with the onset of the civil war in 1975. As a result, many current generation older adults in Lebanon have experiences repeated exposures to conflict and violence throughout much of their adulthood. In Due to changes in fertility and migration in recent generations and the economic deterioration, many older adults, including those suffering from dementia, face increasing challenges in addressing their care needs. The proposed project has two over-arching goals. First, it aims to build new research capacity in Lebanon for the conduct of rigorous epidemiological studies of ADRD and other important aging-related health and social outcomes, with particular emphasis on longitudinal research designs and complex sampling strategies. The research capacity activities will be developed and carried out in close collaboration between the investigative teams at the American University of Beirut (AUB) and the University of Michigan, involving a series of training modules that are relevant to the social and cultural context in Lebanon. Second, it aims to develop a new population-based cohort study and recruit a sample of 3,000 adults aged 60 and older who will participate in a structured assessment of dementia, caregiver needs and arrangements, and other health and social domains. The study will use well-established methods to ascertain ADRD in a population-based context modeled after population surveys of ADRD in the US, including the Health and Retirement Study (HRS), and the Harmonized Cognitive Assessment Protocol (HCAP). The study intends to generate important new knowledge on novel risk factors for ADRD, especially as it relates to the role of prolonged exposure...