Lebanon is aging rapidly, yet data on dementia are almost nonexistent. Related studies on cognitive aging in our archive look for biomarkers in brain folds, the retina, or grip strength, but all of them rely on tools that have never been validated in Arabic. LSAHA fills that gap: it is the first large population-based validation of a cognitive battery in an Arabic-speaking country, where 15 years of civil war and economic collapse may have reshaped the very pathways of brain aging.
The researchers recruited 3027 people over 60 from Beirut and the Bekaa Valley to capture both urban and rural populations. Each participant completed a 30–45-minute battery covering five domains: orientation, memory, language, visuospatial skills, and executive function. The tests were translated into the Lebanese dialect, letters for verbal fluency were swapped for Arabic equivalents, and participants were allowed to name landmarks instead of addresses. The data were then examined with confirmatory factor analysis to determine whether the tests truly measure a general cognitive factor and its five components.
The model fit the data well: memory and executive function performed best. The overall cognitive score declined with age (correlation -0.41) and rose with education (above 0.5). Women with low education scored lower than men, but at higher education levels the difference disappeared. People in poor health and those with memory complaints also scored worse. Internal consistency of the tests was high (Cronbach's alpha 0.79–0.90).
This work stands out from related studies because it validates not a single biomarker but a comprehensive tool for measuring cognitive function in a new cultural setting. It shows that the international HCAP battery can work in the Arab world, where only three validated tests existed before. Lebanon and its neighbors now have a benchmark for comparison with the US, Europe, India, and China, as well as a foundation for studying unique risk factors such as war and economic stress.
The next step is to create normative scores for the Lebanese population and to classify mild cognitive impairment and dementia. Longitudinal follow-up of the same participants will help separate aging from generational effects. The battery may also be adapted for other Arab countries to build a regional data network.
The results will influence dementia epidemiology, geriatrics, and public health in the MENA region. They will also provide material for cross-cultural comparisons of cognitive aging.
Conduct retesting after several years to measure individual changes. Develop cutoff values for diagnosing cognitive impairment based on the scores obtained.
The work directly addresses the shortage of validated cognitive tools for Arabic-speaking older adults. It also touches on how chronic stress and socioeconomic hardship affect cognitive aging in resource-limited settings.
Lebanon has no standardized addresses, so the question "Where are you?" had to be rephrased: participants could name the nearest landmark, such as a mosque or a market. The analogy of a clock that "measures time" did not work, because in the local context a clock "gives time."
Not published on arXiv. Here are its page, the PDF and the formalization: you can check it yourself, not only read our account.