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Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA)
Elbejjani, M.; El Asmar, K.; Chaaya, M.; Sanjar, G.; El Sammak, A.; Langa, K.; McCall, S.; Mehio Sibai et al.. medRxiv (preprint), 2026-09-07
Topic: Risk, prevention and care in population studies
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. 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. 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. 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.
Key findings
- CFA results demonstrated good to excellent model fit across general and domain-specific cognition.
Why it matters
This study adapted and evaluated a comprehensive cognitive assessment battery in an Arabic-speaking population in Lebanon and found good to excellent model fit. It establishes research infrastructure for cognitive aging and does not test any treatment, cure or prevention.
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Study details
- Participants3,027
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 30 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on impact for its field and year, so that was left out: it earned 28 of the 94 points we could judge it on, which is 30 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv (preprint)) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,027 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 0 / 7 | Cited 0 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Carlos F. Mendes de Leon: h-index 78 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 2 countries |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 28 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 28 of the 94 points we could judge it on is 30 out of 100. |
| Total | 30 / 100 | Capped to 16 because this is not a peer-reviewed article. |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Elbejjani, M., El Asmar, K., Chaaya, M., Sanjar, G., El Sammak, A., Langa, K., et al. (2026). Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA). medRxiv (preprint). https://doi.org/10.64898/2026.09.02.26362058
Vancouver
Elbejjani M, El Asmar K, Chaaya M, Sanjar G, El Sammak A, Langa K, et al. Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA). medRxiv (preprint). 2026. doi:10.64898/2026.09.02.26362058.
BibTeX
@article{elbejjani2026-676d068e,
author = {Elbejjani, M. and El Asmar, K. and Chaaya, M. and Sanjar, G. and El Sammak, A. and Langa, K. and McCall, S. and Sibai, Mehio and others},
title = {{Implementation and Evaluation of the Harmonized Cognitive Assessment Protocol in an Arabic-Speaking Population: The Lebanon Study on Aging and Health (LSAHA)}},
journal = {medRxiv (preprint)},
year = {2026},
doi = {10.64898/2026.09.02.26362058},
url = {https://doi.org/10.64898/2026.09.02.26362058}
}
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